Bio-iT and HealTHcare in india

Bio-iT and HealTHcare in india

March 2014

Department of BiotechnologyMinistry of Science and Technology

Government Of India

FOREWORD

BIOIT and Healthcare are at the forefront of biotechnology revolution. Over the

past decade, the bioinformatics market has significantly evolved across the globe

owing to increasing application of genomics in biotech and pharmaceutical research

& development. This growth in the global bioinformatics market has positive

implications for the Bio-IT industry.

The “BIOIT and Healthcare in India” commissioned by DBT and prepared by ABLE

in collaboration with NASSCOM provides a detailed overview of the BIOIT and

Healthcare industry in India. India, with the availability of highly qualified manpower

in the fields of biology and computational sciences as well as a proven track record

in IT/BPO is well positioned to capitalise on this opportunity. This report projects an

annual market growth rate of 15.8% and the global bioinformatics sector is expected

to be valued at USD 9.1 billion by 2018 while the global health-informatics sector is

projected to reach USD 56.7 billion by 2017.

The Indian government, industry players and academic institutions need to adopt a

concerted approach to capitalise on the sector‘s true potential and garner a larger

share in the global market. Going forward, the bio-IT sector is expected to remain

on an uptrend and reach USD 10.2 billion by 2025; of this, the bioinformatics sector

is expected to contribute USD 2.7 billion with health informatics constituting the

remaining.

Likewise the health informatics sector is set to attract increasing interest from the

government and private sector. Health informatics’ potential in aiding inclusive

healthcare, enabling efficient public health management and improving the health

delivery process are some of the prime factors contributing to bio-IT’s growth.

Moreover, India, with its IT and biotechnology expertise as well as cost advantage,

English-speaking workforce and concerted efforts from academia groups, the

government and industry players, has the potential to considerably transform the

bio-IT sector and establish its mark on the global map.

Dr. K. Vijay Raghavan

Secretary, Department of Biotechnology, Government of India

FOREWORD

It gives us great pleasure to write the forward to the BIOIT and Healthcare in

India report. Scientific advances in drug discovery, molecular biology, genomics,

proteomics, chemistry and Pharmacogenomics yield vast amounts of data. The

global health-informatics sector is projected to reach USD 56.7 billion by 2017

(bioinformatics sector globally is estimated to be around 9 billion). This report

estimates that India will grow at 15.8%. Bio-IT enables researchers to organise,

analyse and interpret the data, handle bio processing systematically, shorten product

and process lifecycles, make sense of the complex interaction between variables

and derive logical conclusions and actionable results within shorter time-frames.

India offers integrated Bio-IT solutions through contract research organizations

(CROs). Solutions include biological and chemical databases, data analysis, and data

mining, biomedical text mining and customized tool development among others.

The momentum is expected to be sustained, as bioinformatics would continue to

benefit from plunging sequencing costs and increased global drug R&D. Likewise,

the health informatics sector is set to attract rising interest from the government and

private sector. Health informatics‘ potential in aiding inclusive healthcare, enabling

efficient public health management and improving the health delivery process

are some of the prime factors contributing to bio-IT‘s growth. India, with its IT and

biotechnology expertise has the potential to considerably transform the bio-IT sector

and establish its mark on the global map.

ABLE NASSCOM

Bangalore New Delhi

Dr. P. M. Murali

President ABLE

Mr. R. Chandrashekar

President, NASSCOM

acknowledgmenTs

We would like to express our appreciation to all those who provided their

insights and suggestions during the course of this report. We sincerely

thank the industry participants including educational institutions in India

and abroad, hospitals, ABLE member companies, and NASSCOM and

its member IT companies, who gave us their valuable time and insights,

which played a crucial role in stimulating the ideas presented in this study.

We also acknowledge the contribution and research support provided by

Aranca. Special thanks to Department of Biotechnology, Ministry of Science

and Technology, Government of India for commissioning the report and to

Dr. Shailja Vaidya Gupta, Director, International Cooperation, DBT for the

guidance provided.

Contents

Executive Summary 1

Advantage India 5

India: Proven track record in IT/ITES, a roadmap for bio-IT 6

Perfect blend of science, technology and innovation 7

Home to young, well qualified and affordable human capital 9

What is Bio-IT? 13

Bio-IT: Global Potential 17

Origin and history of the bio-IT industry 18

Overview of the global bio-IT sector 19

Offerings and applications of the global bio-IT sector 23

Bio-IT forecasts – How big is the global opportunity? 23

Bio-IT sector’s contribution to global healthcare 25

Bioinformatics competence in handling biological data deluge 26

Information management in hospitals using medical informatics 28

Rendering the drug discovery process efficient and cost-effective 29

Bio-IT: The Indian landscape 33

Origin and history of bio-IT in India 34

Overview of the Bio-IT sector in India 35

Evolving climate of bio-IT in India 37

India’s bio-IT sector to witness increased domestic and global demand 38

Bio-IT Meeting India’s Healthcare Needs 41

Aiding India’s ambitions in developing medicines 42

Disease-specific databases to enable efficient tracking and treatment 44

Access to quality healthcare through telemedicine and m-health 45

Efficient Management of Health Information 47

Role of government in bio-IT – A global perspective 49

Early government initiatives and ongoing grants critical to US’ success in this field 50

Growth in bio-IT in EU primarily through collaboration 51

APBioNet providing impetus to bio-IT in Asia-Pacific 52

Role of Government in Indian Bio–IT sector 55

Establishment of BTISnet – one of the key breakthroughs 56

BPI – 2004 an effort towards making India globally competitive 58

Government’s bio-IT efforts visible in Five-Year Plans 59

Additional efforts required to address Ethical, Legal and Social Issues (ELSI) 62

Recommendations and reforms required for regulations 65

– Developing a long-term policy with set ethical standards 65

Infrastructure Landscape 67

Human Resource 68

– Global picture 68

– Current status and challenges faced by India in Human Resource 69

– Recommendations and reforms to bridge the gap 71

Funding 76

– Global picture 76

– Current status and challenges faced by India in funding 78

– Recommendations and reforms to bridge the gap 83

Connectivity 86

– Global Picture 86

– Current status, challenges and recommendations for connectivity in India 88

Conclusion 91

Annexures 93

Annexure 1: Introduction to India’s healthcare needs 94

Annexure 2: Company Profiles of Major Players in India 105

Figure 1 : Allocation of budget (INR billion) to the DBT during the Five-Year Plans 8

Figure 2 : India’s working age population* (mn) to outpace China by 2025e 10

Figure 3 : India – Second most attractive destination worldwide for people skills and availability 11

Figure 4 : Wide spectrum of bioinformatics applications 14

Figure 5 : Relationship between biotechnology, pharmaceutical, medical and IT 15

Figure 6 : Applications of bio-IT tools across the healthcare value chain 16

Figure 7 : History of bioinformatics in the global landscape 18

Figure 8 : History of health-informatics in the global landscape 19

Figure 9 : High returns generated from HGP 20

Figure 10 : Evolution process of data storage 22

Figure 11 : Bioinformatics support every stage of “-omics” used in diagnostics 26

Figure 12 : Sharp fall in the cost of DNA sequencing (USD/Mb) and genome (USD mn) 27

Figure 13 : Integration of information technology with hospital management systems 29

Figure 14 : Time required for conventional drug discovery (~14 years) 30

Figure 15 : Integration of bioinformatics to aid drug discovery at various stages 31

Figure 16 : History of bioinformatics in the Indian landscape 34

Figure 17 : Rising revenue from bioinformatics (INR bn) 35

Figure 18 : Trend showcasing move towards a balanced revenue stream 36

Figure 19 : India – Second most attractive destination globally for people skills and availability 39

Figure 20 : Telemedicine 45

Figure 21 : Progress with the implementation of HMIS portal 48

Figure 22 : Progress with the implementation of HMIS portal 51

Figure 23 : Number of bioinformatics specific publications by BTISnet 56

Figure 24 : BTIS network spread across India 57

Figure 25 : Envisioned framework under the Bioinformatics Policy of India (2004) 58

Figure 26 : Five-Year Plans focused on the bioinformatics sector 59

Figure 27 : Benefits with the full adoption of HIS 61

Figure 28 : Basic principles outlined across various studies related to the role of ethics in genetic research 63

Figure 29 : Major non-profit organisations supporting global human capital development 69

Figure 30 : Timeline for introduction of key educational bioinformatics courses in India 70

Figure 31 : Initiatives undertaken to reverse the brain-drain in scientific research 73

Figure 32 : Genetic–related funding by NIH in the range of USD7.8–8.2 bn per year 76

Figure 33 : Allocation of budget (INR billion) to DBT during the Five-Year Plans 79

Figure 34 : Funding lifecycle 80

Figure 35 : Major portion of funding to healthcare 80

Figure 36 : Bio-IT funding innovation cycle facing valley of deaths 82

Figure 37 : Global research groups leveraging on high–bandwidth connectivity 86

Figure 38 : EU-IndiaGrid 89

Figures

Figure 39 : Comparison of healthcare status in India and other developed and developing economies 94

Figure 40 : Healthcare revenues – USD78.6bn in 2012 95

Figure 41 : Hospitals command largest share (2012) 95

Figure 42 : India – home to highest FDA approved plants* 96

Figure 43 : Rise in the number of DMFs filed by India 96

Figure 44 : Health insurance market size (USD m) in India 97

Figure 45 : Growth in health insurance premium (USD bn) 97

Figure 46 : Health insurance market size (USD m) in India 97

Figure 47 : Growth in lifestyle diseases 97

Figure 48 : NHP goals 98

Figure 49 : MDG goals 99

Figure 50 : NHRM functions 100

Figure 51 : Allocation under the 12th Five-Year Plan (USD55.1 bn) vis-à-vis 11th Five-Year Plan (USD19.8 bn) 101

Figure 52 : Low spending on healthcare in India 102

Figure 53 : Skewed picture of public-private spending 102

Figure 54 : Low spending on healthcare in India 103

Figure 55 : Infrastructure and human capital 104

Bio-IT and Healthcare in India

1

Executive SummaryBio-IT is critical to modern lifescience research and has witnessed tremendous progress in the past few decades. Application of bio-IT has been widespread across all facets of medicine – from clinical research to drug development and personalised medicine. There lies little doubt with regard to the sector’s potential, with the US Human Genome Project (HGP) alone having an economic impact worth USD1 trillion1. While the global bioinformatics sector is expected to be valued at USD9.1 billion by 20182, the global health-informatics sector is projected to reach USD56.7 billion by 20173.

India, with the availability of highly qualified manpower in the fields of biology and computational sciences as well as a proven track record in IT/BPO, is well positioned to capitalise on this opportunity. Moreover, cost savings and quality processes further emphasize the country’s position as a prime bet for global bio-IT firms that are majorly driven by outsourcing. However, ambiguity over data security laws, absence of a long-term, sector-focused policy, coupled with lack of infrastructure, connectivity and an interdisciplinary workforce, could impede the envisioned growth. Nevertheless, reforms in the form of long-term policies, joint programmes with updated curricula and access to seed- and bridge-funding, among others, would entrench India’s positioning in the global bio-IT space.

1 The Impact of Genomics on the U.S. Economy, by Battelle Technology Partnership Practice for United

for Medical Research (UMR), 20132 Bioinformatics Market - Global Industry Size, Market Share, Trends, Analysis and Forecast, 2012–2018,

by Transparency Market Research, 20123 Healthcare IT Market Research Report, by MarketsandMarkets, 2013

Executive Summary

2

Global Bio–IT to witness double digit growth over 2012-18.

The global bio–IT sector expanded at an exponential pace with significant success achieved in

the latter part of the 20th century. The post-genomic era, marked by the completion of HGP, paved

the way for bioinformatics; the sector increased at a CAGR of 8.2% to USD2.3 billion over 2005–12

and is pegged to register a CAGR of 25.4% and aggregate USD9.1 billion by 2018. Factors such as

declining DNA sequencing costs, rising public–private funding and technological advancements

in bioinformatics tools and platforms are likely to continue bolstering the market. Likewise, the

health-informatics sector is estimated to reach USD56.7 billion by 2017 from USD40.4 billion in 2012

due to the changing demand scenario in terms of IT adoption in clinical management and hospital

administrative solutions & services.

Bio-IT: Robust growth in India, expected to reach USD10.2 billion by 2025

The Indian bio–IT sector has evolved at a significant pace over the last decade. The bioinformatics

sector recorded a CAGR of 12.8% to USD55.0 million over 2007–13, supported by declining DNA

sequencing costs and increasing R&D spending by public and private players. Also, the health-

informatics sector has gained utmost precedence across both private and public initiatives, with

new healthcare models (such as telemedicine) aiding inclusive healthcare across the country. The

Indian government, industry players and academic institutions need to adopt a concerted approach

to capitalise on the sector’s true potential and garner a larger share in the global market. Going

forward, the bio-IT sector is expected to remain on an uptrend and reach USD10.2 billion by 2025;

of this, the bioinformatics sector is expected to contribute USD2.7 billion with health informatics

constituting the remaining.

Rising domestic and outsourcing demand aiding India’s growth

There is a scintillating era of growth and global acknowledgment for the Indian bio-IT industry,

going forward. Within India, a quantum leap in opportunities is likely to arise from pharmaceutical

companies and hospitals adopting bio-IT tools and software. The country also stands to benefit

from an expansion in the global bio-IT market as leading companies in the US and UK outsource

services. Within bioinformatics, there have been significant investments in contract research,

clinical trials, contract manufacturing and drug development. Technological adoption in healthcare

administration, on the other hand, is supporting health informatics. While non-clinical models, such

as telemedicine, mobile health, and digital health, are already supporting the bio-IT’s growth, a

significant impetus would also arise from the development of gene-based diagnosis and treatments

specific to the Indian population.

Emulating the IT success story in bio-IT

India has witnessed exponential growth in the IT sector and has evolved to become the global IT

hub. This success, led by the collaboration between the government, academia groups and industry

players, can be emulated for achieving success in the bio-IT sector. The requisite IT infrastructure,

coupled with adequate biotechnology expertise, offers the country an edge in bio-IT outsourcing

vis-à-vis other countries. A confluence of competency in research and innovative solutions, and

a low-cost advantage (nearly 50% below the cost incurred by western counterparts in terms of

contract research and clinical trials4) enhances India’s attractiveness. With the global bio-IT space

set to register a CAGR of 25.4% over the next six years, the Indian advantage can play a key role in

assisting other global economies across their value chain.

4 Overview On Contract Research And Manufacturing Services (Crams) And Its Present Status In India,

by Asian Journal of Pharmaceutical and Clinical Research, 2013


3

Critical roadmap essential to capitalise India’s advantage on a global scale

To achieve its potential, India would need to overcome a few obstacles, the most critical of which

relate to people, finance and infrastructure. There is a need for a vast pool of people trained in the

fields of lifesciences, computer science, mathematics and physics. Furthermore, long R&D lead

times alongside the risk associated with new technology sectors has made it difficult for companies

to obtain timely and adequate financing. There is a shortage of seed- and top-up funding, thereby

hindering start-ups and established companies’ expansion. Besides, lack of awareness with

regard to the existing Intellectual Property Rights (IPR) regime as well as ethical and environmental

concerns further curtails the sector’s growth.

Formulation of a long-term policy is the key to building a forward-looking roadmap for the bio-IT

sector. Reforms directed towards existing human resource infrastructure, with a view to produce

sufficient bioinformaticians and thereby capitalize on the global demand, needs to be in place.

Lack of learned teachers and the corresponding workforce can be addressed by formulating joint

programmes with the course outline encompassing interdisciplinary knowledge across both biology

and IT. Also, curriculum development at the university and institution level, coupled with practical

exposure for students, would aid the development of a strong human infrastructure. Furthermore,

low bandwidth connectivity hindering the collaboration between industry players, academia groups

and the government should be addressed so as to build the requisite infrastructure for executing

quality and accelerated research. Also, data confidentiality concerns and allied ethical issues in

gene research need to be handled by establishing a strong and long-term IPR regime. Funding

initiatives to boost intellectual and entrepreneurial research activities during product development

need to be undertaken by concerted efforts from the government (in the form of sector-focused

funds) and private players (in the form of VC/PE and angel investments).

Executive Summary

4

Key recommendations addressing the sector’s challenges are mentioned below.

No Recommended actions Responsibility

1 Human resource

Launch multi-disciplinary programmes Academia groups with insights from industry players

Redesign the curriculum based on skills and capability gap analysis

Government at the forefront with inputs from industry players

Collaborate with industry players and offer academic internships

Academia groups with support from industry players

2 Connectivity and Collaboration

Provide robust and high-speed network architecture to enable collaboration among research centres across India

Government

Raise internet penetration in rural areas Government

Organize industry academia workshops on key topics Industry with help from national and international research institutes

Evaluate current systems of partnerships and shared public-private resources

Government at the forefront with inputs from industry players and academia groups

3 Funding

Conduct sector awareness programmes to improve understanding

Government with inputs from industry players and academia groups

Commence a bioinformatics focused seed and growth fund

Government as well as other public and private PE/VC firms

Recognize vital research areas needing high quality of public and private financing

Government with support from industry players

4 IPR Regime

Establish a separate body to ensure compliance with the desired level of confidentiality

Government along with industry players

Launch a one-stop portal encompassing in-depth information related to IPR


Increase emphasis on innovation, culture of safety, efficiency and sharing



5

Advantage India

India, capitalising on the underlying potential, is envisaged to become one of the major contributors to bridge the gap in demand for bio-IT and emerge as a global hub for bio-IT tools and services. The country’s notable success in the IT sector, coupled with ample biotechnology skill sets, offers it an upper hand vis-à-vis other countries. A low-cost structure is the key differentiating factor. Though employee cost has increased over the years, India is still considered one of the most attractive destinations due to a blend of low-cost and high quality. The cost component is supported by access to highly qualified skilled manpower that is well versed in business and technical skills related to chemistry, biology and IT. In addition, the English-speaking capability of a young populace is an important factor differentiating India’s human capital from other low-cost economies such as China. Also, the innovation culture, supported by government efforts and entrepreneurial vigour, plays a key role in steering India’s contribution to lifescience R&D. On the whole, India’s competency in research and innovative solutions, along with the cost advantage, has the potential to fuel growth in the domestic as well as global bio-IT market.

Advantage India

6

India: Proven track record in IT/ITES, a roadmap for bio-IT

Success in the Indian IT/BPO sector and its emergence as a global hub

The Indian IT/BPO sector exhibited exponential growth in the last decade and carved a niche on

the global IT map. The sector has not only revolutionized India’s image on the international platform

but also played a key role in the country’s growth. Also, it proved to be beneficial for India’s socio-

economic growth by significantly contributing to the GDP and increasing urban employment as well

as exports. The sector’s contribution to the economy increased to 8% of GDP in FY135 from 1.2%

in FY98. Furthermore, during the course of development, the sector transformed the education

sector (particularly engineering and computer science) and provided employment to nearly 10

million Indians6. In addition to domestic contribution, India’s IT/ITES service offerings have rendered

several benefits to global players, which not only source low-end medium complex work but also

high-end research and analytics from the country.

To transform India into a trusted sourcing destination, several companies in the IT/BPO sector

are adhering to world-class standards such as ISO 270001, EU directives, Sarbanes-Oxley Act,

Payment Card Industry, Health Insurance Portability and Accountability Act and Gramm-Leach-Bliley

Act. These practices offer solutions for issues related to data protection. To further strengthen

the business environment, Data Security Council of India has defined industry standards for

data security and privacy. Notably, most Fortune 500 and Global 2000 corporations trust Indian

capabilities and are sourcing IT/ITES services from the country; India accounted for 52% of the

global outsourcing market in FY137.

Robust IT infrastructure, a by-product of the IT/ITES sector’s growth in India

The government’s concerted efforts, coupled with a host of other initiatives undertaken by

academia groups, association bodies and industry players, are the hallmarks of the IT/ITES sector’s

success in India. A robust environment created by timely government policies and increased

public-private collaboration has buoyed the sector’s growth. Some other positive drivers include

establishment of software technology parks (STP) and special economic zones (SEZs) in addition to

the extension of tax holidays to the IT sector. Moreover, single window clearance for start-ups, thus

ensuring hassle-free set up, has encouraged the entry of entrepreneurs in the sector. Apart from

government initiatives, access to affordable and quality manpower—made possible by the efforts of

academic institutions—has supported the development of requisite educational infrastructure. This

factor coupled with the three-pronged approach of the government, academia groups and industry

players has led to the establishment of robust IT infrastructure in India. Also, the private sector, in

collaboration with the government, helped in setting up the necessary business infrastructure with

world-class facilities and services.

With established IT infrastructure, alongside significant growth prospects, India is well-positioned to expand in the bio-IT sphere

Tremendous growth in IT/ITES has led to the establishment of commendable back- end IT

infrastructure such as high-tech data labs, IT professionals, and improved bandwidth connectivity

in various cities. The proven IT expertise and infrastructure act as a building block for the country’s

bio-IT sector and played a key role in attracting overseas business. Also, with its ingredients of

strong educational infrastructure at affordable rates, as leveraged by the IT sector, global players

would remain inclined towards sourcing their bio-IT work from India in the coming years.

Novel technological trends in the IT/ITES sector can be applied in the field of lifescience for economic

and social development. Disruptive IT technologies, such as cloud computing and big data analysis,

5 http://egov.eletsonline.com/2013/07/software-technology-parks-of-india/6 IT & ITeS Industry in India, by IBEF, 20137 IT & ITes sector Outlook 2014, by Dun & Bradstreet, 2013


7

are likely to significantly contribute to India’s bio-IT growth. Huge growth prospects exist within

India’s big data industry, having considerable applications in the healthcare sector; the industry is

expected to record a CAGR of 70% to USD1 billion over 2012–158. Furthermore, services, such as

cloud computing, which facilitate big data analysis in the field of bioinformatics, are estimated to

reach USD16 billion by 20209. For the bio-IT sector, cloud computing appears to be an obvious fit

as it can effectively resolve storage, transfer, security and privacy issues that arise due to the huge

quantum of data.

Renowned IT service providers leveraging skill sets in the lifescience domain

To capitalise on bio-IT’s global potential and increasing government focus on modernising the domestic

healthcare sector, major IT companies are forging synergies and entering the lifescience domain. IT

companies, such as TCS, Infosys, and Wipro, were among the forerunners in the bio-IT space. These

entities have expanded their offerings and built core competencies to support proteomics, genomics,

drug discovery, data analysis services, and scientific data management systems.

Similar fundamentals and an enabling business environment, as in the case of the IT/ITES sector,

would help in realising bio-IT’s significant potential in exports as well as the domestic market.

Perfect blend of science, technology and innovation

Strengths in building a knowledge- and innovation-based economy

With sustained economic growth over more than a decade, the Indian economy witnessed

transition from the one being driven by agriculture to one of the most important knowledge and

innovation economies worldwide. Strong fundamentals, in the form of abundant talent due to a

young demographic profile, act as a huge competitive advantage. This fact is supported by a large

number of internationally-renowned institutions offering English-speaking courses, especially in

sciences. Also, a vast network of government funded R&D laboratories showcasing multidisciplinary

know-how, growing public-private collaborations and WTO-compliant IP law, among others, have

aided the innovation culture in India. Rising importance of science fields in the government’s

long-term plans has particularly boosted India’s focus on becoming an innovation economy.

Interestingly, India ranks 66th among 142 countries in terms of innovation capacity and efficiency10.

The country holds the number one position across Central and South Asia, and ranks 11th in the

global innovation efficiency ratio.

Emergence of India as the global IT outsourcing hub, displaying world-class IT facilities, highlights

its potential to become one of the primary destinations for technological innovations. The country

ranked third11 due to forethought vision and focus on innovation. Separately, in another survey

undertaken to gauge the technology confidence worldwide, India received the best ranking among

12 countries for all of the criteria, with the exception of government incentives. With a score of 72,

the country is the leader followed by the US (65), UK (50), China (64), Korea (58) and Russia (50)12.

Also, India stood 34th after leaping 10 positions in the 66-nation index13.

Innovation – Government’s new strategy towards a knowledge-based economy

Apart from the demographic dividend, the government has been focusing on achieving the strategic

8 NASSCOM9 NASSCOM10 Global Innovation Index 2013, by Cornell University, USA, European Institute of Business Administration

and World Intellectual Property Organization, Minister for Science and Technology, 201311 Global Tech Innovation Index by KPMG, 201312 Global Tech Innovation Index by KPMG, 201313 IT Industry Competitiveness Index 2011, by Economist Intelligence Unit, 2011

Advantage India

8

goal of becoming an innovative, knowledge-based economy. The government aims to establish

a new innovation ecosystem, which would facilitate partnering with global research centres and

ensure fund availability through the wide-ranging National Research Fund, as reflected in the 12th

Five-Year Plan (2012–2017).

Science & Technology has been recognized as one of the domains where multifold innovation

opportunities exist. The field has been attracting accelerated government funding due to large-

scale progress in biology and technological advancements that generate high quality data. In the

field of biotechnology, particularly, there has been a considerable increase in outlays over the past

few decades. Since the establishment of Department of Biotechnology (DBT) in 1986, the budgetary

allocation has increased manifold from INR404 million (USD6.9 million) in FY88 to INR1.1 billion

(USD18.8 million) in FY98 and INR14.9 billion (USD255.1 million) in FY1314, indicating the importance

of the sector’s R&D and infrastructure development. Bio-IT, recognized as a frontline applied

science and a facilitator for the study of biological data deluge, would benefit from the expansionary

budget for biotechnology.

Figure 1 : Allocation of budget (INR billion) to the DBT during the Five-Year Plans

Source: Planning Commission Five-Year Plans

0

100

200

300

400

500

600

700

800

900

7th Five Year Plan 8th Five Year Plan 9th Five Year Plan 10th Five Year Plan 11th Five Year Plan

Science & Technology Biotechnology

The Indian government announced 2010–20 as the “Decade of Innovations”, recognising its

potential contribution to economic and social development. In line with this, a National Innovation

Council was established. Likewise, Science, Research and Innovation System for High Technology

led path for India (SRISHTI) is the main objective of the new Science, Technology and Innovation

Policy (2013). The policy aims at leveraging benefits from storing linkages between science,

technology and innovation. Furthermore, an India Innovation Fund was launched to provide venture

funding for innovative ideas in the fields of ICT and lifesciences. Recently, the Ministry of MSMEs

sought approval to begin a dedicated fund – India Inclusive Innovation Fund – to foster grass-root

innovations having social as well as modest economic returns.

Enabling environment driving investment levels across the R&D value chain

Rise in demand for knowledge-based activities combined with expansionary budgets has increased

investments in R&D. After a significant decline in 2009, India began investing in R&D and raised the

level; as a percentage of GDP, R&D stood at 0.9% in 201315, up from 0.8% in 200316. However, the

figure has been below 1% of the GDP. Increasing Gross Expenditure in Research and Development

(GERD) to 2% of the GDP has been the national objective for some time now17.

India, with its strengths and capabilities supported by an efficient and low-cost manufacturing

model, is well placed to emerge as a competitive platform for various segments across the R&D

14 Annual Budget 2013, DBT India, 201315 2014 Global R&D Funding Forecast, by Battelle, 201316 Science Report, by UNESCO, 201017 Science, Technology and Innovation Policy 2013, by DBT, 2013


9

value chain. Furthermore, availability of a vast pool of qualified talent and eagerness of overseas

Indians to return to the country augurs well with the foreign talent entering the country for cutting-

edge research opportunities. Besides, most companies shifting from a single large R&D facility are

increasingly betting on the country’s potential. India is gradually surfacing as a global innovation

hub with the establishment of over 1,000 MNC R&D captive centres 18.

India among the preferred CRO and CTO locations for drug development

Of the total bioinformatics revenue, outsourcing activities account for a major share in India. In

the event of an economic slowdown, Contract Research Outsourcing (CRO) and Clinical Trial

Outsourcing (CTO) are important sources of revenue for pharmaceutical giants, and an opportunity

for growth in the domestic bio-IT sector. With intrinsic benefits such as high quality, low-cost R&D

and cheap availability of knowledge resources, India is well placed to capitalize on such initiatives.

Major activities performed as part of CRO and CTO involve pre-clinical phases in a drug discovery

process and clinical trials. In addition, to counter-balance patent expiries and dwindling product

pipelines, foreign pharmaceutical companies seek to outsource bio-IT services for drug discovery.

Notably, global pharmaceutical companies outsource a large percentage of their high-end services

such as clinical trials (35%) and drug discovery (25%)19. Outsourcing is expected to expand further as

companies seek to counter high drug development costs. In the drug development process, clinical

trials and drug discovery account for 62% and 26% of the total drug development expenditure,

respectively. The figures suggest outsourcing of these businesses to India, vis-à-vis other developed

nations, reduces the overall cost by 30–40%, while outsourcing core bioinformatics services leads

to a cost advantage of up to 60%20.

Home to young, well qualified and affordable human capital

Availability of abundant manpower at affordable rates in India is sustainable over the long term. A

young demographic profile, where more than millions of students enrol for the talent base each

year, offers a perfect mix and scale of human resources. A strong workforce coupled with ease of

access, low-cost, and quality of education places India ahead of its counterparts.

Reaping benefits from a young demographic profile

Growth in the young population base is a demographic dividend. India, currently with a population of

around 1.3 billion, is forecast to surpass China and become the most populous country in the world

by 202521. More than 50% of the country’s total population is below the age of 25 and nearly 65% is

below 35. Interestingly, India’s median age at 26.5 years is much below that of China (35.9 years) and

the US (37.1 years). By 2020, the average age is expected to hover around 29 years vis-à-vis China and

the US (37 years), Europe (45 years) and Japan (48 years)22. Effective utilization of this demographic

advantage differentiates India’s growth story from other emerging and developed economies.

18 http://timesofindia.indiatimes.com/business/india-business/25-global-companies-set-up-RD-centres-

in-India-in-last-18-months/movie-review/22846741.cms19 India, China most preferred CRAMS destinations, by Pharmabiz.com, 201220 Indian Bioinformatics Market Forecast to 2015, by RNCOS, 201221 United Nations22 Economic Survey, Times of India

Advantage India

10

Figure 2 : India’s working age population* (mn) to outpace China by 2025e

Source: United Nations, Aranca research, *working-age population is considered between 15 and 64 years

0200400600800

1,0001,2001,4001,6001,800

Ind

ia

Ch

ina

Eu

rop

e

US

Bra

zil

Ru

ssia

Ind

ia

Ch

ina

Eu

rop

e

US

Bra

zil

Ru

ssia

Ind

ia

Ch

ina

Eu

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US

Bra

zil

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2012e 2025e 2050e

0-14 15-64 65+

Huge pool of qualified workforce in IT and lifesciences a boon for bio-IT

One of the key factors driving bio-IT in India is a large workforce proficient in IT and lifesciences.

Initiatives by the government and private sector led to the creation of a large talent base that, in

turn, helped the industry source employees.

With a strong and high quality educational infrastructure, including IITs, IISC and NITs, India continues

to produce nearly 1.5 million engineers each year23. Apart from the internationally renowned

institutions, such as IITs and NITs, the country has 3,393 engineering colleges24. This, coupled with

the research talent from institutions such as Institute of Bioinformatics and Biotechnology (IBB),

Institute of Bioinformatics (IOB) and Bioinformatics Institute of India (BII), has aided the building of

a vibrant bio-IT industry. With more than 0.5 million science graduates and 4,000 doctorates in

the field of life and health sciences25, India accounts for 10% of the global skilled workforce having

expertise in IT and biotechnology.

Various institutions and state universities have introduced specialised bioinformatics courses in

their post-graduate biotechnology programmes due to its widening scope. For instance, DBT offers

an advanced diploma in bioinformatics at its universities across Madurai, Pune, New Delhi, Kolkata

and Puducherry. Also, the Ministry of Science & Technology has set up a national facility at IIT Delhi,

focusing on the in-silico drug development process based on bioinformatics. With these initiatives,

Indians have developed the pre-requisites for data handling, data mining, genotyping, fingerprinting

and next-generation sequencing, among others. Moreover, the Biotechnology Information

Networking System (BTISnet) (established under the DBT) conducts long-term specialised diploma

courses, such as MTech, MSc and PhD, as well as around 80–100 short-term training courses each

year for enhancing the knowledge of academicians and scientists who are linked to the network26.

Also, five academic Centres of Excellence (CoE) – Jawaharlal Nehru University (JNU), New Delhi;

Indian Institute of Science (IISC), Bangalore; University of Pune, Pune; Madurai Kamraj University,

Madurai; and Bose Institute, Kolkata – were set up by the central government to cater to the field

of bioinformatics. These centres serve as a prominent source of qualified professionals. Currently,

most core bio-IT companies have been set up by the alumni of these premier institutes.

India, home to a sufficient number of qualified institutions, creates quality professionals on par with

international standards. To ensure every institution produces students with world-class knowledge

23 http://www.livemint.com/Industry/HCWB4sLvFBxfIFyNBYtqOP/Degree-in-hand-a-generation-of-

engineers-looks-for-alternat.html24 All India Council for Technical Education25 http://embassyofindiaukraine.in/ukraine.php?key_s=1926 http://www.niobioinformatics.in/achievements.php


11

and skills, several national level examinations such as Bioinformatics National Certification (BINC),

CSIR-UGC National Eligibility Test (NET), and Biotechnology Eligibility Test (BET) exist.

Ease of access and affordability of workforce

India’s emergence as a global IT outsourcing and innovation hub is ascribed to its cost competitiveness

in IT service offerings. Western counterparts continue to source their work from India as it is 3–4x

cheaper. The cost of skilled Indian workforce is reasonably low relative to developed nations. This

renders domestic IT services highly cost-efficient and is also the driver for the significant expansion

in IT-enabled services such as business process outsourcing and knowledge process outsourcing.

Interestingly, in terms of skilled human resource and availability, India has a score of 2.76, much

higher than competitors such as China (2.55) and advanced European counterparts such as

Germany (2.17), France (2.12) and the UK (2.26)27. Also, the cost of establishing and operating a

bioinformatics company in India is very low compared to that in the US. These factors assist the goal

of the domestic bioinformatics sector in becoming a part of the global bio-IT spectrum.

Figure 3 : India – Second most attractive destination worldwide for people skills and availability

Source: AT Kearney, Global Services Location Index, 2011

0.0

0.5

1.0

1.5

2.0

2.5

3.0

India China UK Germany France Brazil

27 AT Kearney, Global Services Location Index, 2011


13

What is Bio-IT?

Bio-IT is the interplay between biology and information technology, encompassing data creation and assembling, data analysis and interpretation, and modelling of various biological phenomena through the use of algorithms and software tools. Bio-IT finds applications in pure biological sciences (bioinformatics) and medical administration & public health (medical informatics).

What is Bio-IT?

14

Bioinformatics: It is an interdisciplinary field that combines biology, computer science, and

information technology capabilities to develop and improve the storage, retrieval, organisation and

analysis of biological data.

Figure 4 : Wide spectrum of bioinformatics applications

Source: Aranca research

Bioinformatics

Pharmaceuticals

Biotechnology

Agriculture

Environment

Forensic biotechnology

Drug development

Clinical diagnostics

Molecular medicine

Personalised medicine

Preventive medicine

Gene sequencing and therapy

Protein structure modeling

Reproductive biotechnology

Microbial genome sequencing

Pest resistance

Crop yield

Nutritional Quality

Drought resistance

Waste cleanup

Alternative energy

Climate change

DNA for legal matters

Medicine: Research-based activities, such as drug discovery and diagnostics, can be simplified in

terms of time and cost by employing bioinformatics. The clinical development process carried out

during drug discovery is also rendered more proficient as a large amount of data can be easily

captured, managed and shared. Bio-IT also plays a major role in developing tailor-made medicines,

specifically for the treatment of therapeutic areas such as cancer and HIV.

Biotechnology: Some significant applications of bioinformatics in biotechnology are sequencing,

comparing and functional identification of genes, and prediction of 3D structure modelling that help

in understanding the physiology and genetic composition of a living organism.

Agriculture: With the help of bioinformatics tools, which facilitate efficient gene sequencing, a

detailed analysis revealing specific characteristics of genomes is made possible. This detailed

genetic information helps in creating an improved, insect-resistant, anti-drought and more effective

crop variety that would enhance productivity. The tools also aid in the development of a superior

breed of livestock, which is comparatively healthier and more disease-resistant.

Environment: Various genome-enabled bioinformatics experiments and modelling practices have

enabled farming of microorganisms that help in activities such as bioremediation. Furthermore,

bioinformatics can help in detecting certain microbial organisms that require carbon dioxide as

their only source of carbon, leading to lower CO2 content and thus improving climatic conditions.


15

Forensic research: From DNA sketches to fingerprinting, bioinformatics plays an important role in

forensic research. Technological advancements, such as DNA microarray sequencing, Thin Film

Transistor (TFT) biosensors and effective algorithms, have supported accurate storage and testing

of genes. This development can assist medical researchers, forensic pathologists, anthropologists,

forensic dentists, fingerprint experts, radiologists and physical evidence recovery specialists.

Medical-Informatics/Health-Informatics: This field broadly encompasses IT tools and software

used in hospitals for data management and public health management (telemedicine, digital

health and tele-education). The efficiency of administration-based activities, such as patient record

management, clinical trial data management and public health activities (telemedicine, digital

health, among others), can be enhanced by employing health informatics. It has applications in

Hospital Information Systems (HIS), including data management, and Decision Support Systems

(DSS). Health informatics can also facilitate access to healthcare facilities in far-flung regions or rural

areas that lack medical infrastructure.

Figure 5 : Relationship between biotechnology, pharmaceutical, medical and IT


Bio InformaticsHealth

Informatics

Biotechnology and

Pharmaceuticals

Information Technology

Medical- Hospitals

- Public Health

The scope of this study is limited to the application of bio-IT to critical aspects of healthcare.

The report focuses on the benefits garnered by the global healthcare industry through effective

deployment of bioinformatics, and also emphasises on how India showcases the potential to

emerge as one of the leading champions in this field. Yet, to harness the true potential, the country

needs to step-up changes and address underlying issues. Low penetration of healthcare services

and lack of innovation in the private sector are the major supply-side challenges faced by the

healthcare industry. Bio-IT is becoming increasingly relevant to address these challenges and tap

the industry’s full potential.

Application of bio-IT in the healthcare value chain

Application of bio-IT products and tools has helped in leveraging the lifesciences R&D value

chain across the pharmaceutical and healthcare sectors, spanning basic research, drug discovery

and development, clinical trials and healthcare delivery. Bioinformatics has applications in the

development phase, whereas health informatics is used in the trial and delivery phases.

What is Bio-IT?

16

Figure 6 : Applications of bio-IT tools across the healthcare value chain


Genomics

Proteomics

Microarrays

Cheminformatics

Pharmacogenomics

In silico research

Preclinical trials

Clinical trials

Patient Record

Clinical Record

Hospital

Information

System

EMR/PACS/

CPOE/CDSS

Telemedicine

M-Health

Life Sciences Research Tools

Drug Development

Providers/

Pharmacies

Healthcare delivery

Bioinformatics

Medical Informatics

Bio –IT Tools

Value Chain


17

Bio-IT: Global Potential

It was in the late 1950s when the domain of bio-IT was born. Over a period, the sector gained tremendous success with its rising applications in addressing biomedicine as well as healthcare needs of the world. The post-genomic era began in the early 2000s driving the bioinformatics sector to a new level – a CAGR of 8.2% to USD2.3 billion over 2005–12. The data deluge led by declining DNA sequencing costs coupled with expanding public–private funding and technological advancements are the key drivers for the robust growth. Likewise, the health informatics sector led by rising adoption of IT in managing and delivering health was pegged at USD40.4 billion in 2012. Over the years, while biomedicine has seen advent of new field like personalised medicine, IT infrastructure has evolved to platforms such as cloud computing. Going forwards, the global bioinformatics sector is expected to aggregate USD9.1 billion by 2018 and health informatics sector to touch USD56.7 billion by 2017.


18

Origin and history of the bio-IT industry

The origin of bio-IT in the lifesciences domain dates back to 1956, when the first protein to be

sequenced was that of bovine insulin. Almost 10 years later, bioinformatics found application in the

sequencing of yeast alanine tRNA, the first nucleic acid. In 1968, Margaret Dayhoff created the first

bioinformatics database for protein sequences. A quick snapshot of the history of bioinformatics

indicates considerable advancements in the number and type of databases and software tools

available for application areas as well as in government policies.

Figure 7 : History of bioinformatics in the global landscape


1956

Origin of bioinformatics–Sequencing of

Bovine insulin protein

1988

Foundation of National Center for

Biotechnology Information (NCBI) in US,

development of BLAST and FASTA tools

1967

Sequencing of first nucleic acid of yeast

alanine tRNA 1968

First database developed by Margaret

Dayhoff consisting of all the known

sequences 1973

Building of Protein Data Bank, Compilation of

9 X-ray crystallographic protein

structures 1977-1986

Rise in the number of databases: Staden,

GenBank, FASTP/FASTN, and SWISSPROT1987

Bioinformatics boosted with DOE OHER’s

initiative to sequence human genome

2002

Rise in bioinformatics job market with many

new players entering the sector 2006

Discovering newer avenues for application of

bioinformatics: Synthetic biology and

Pharmacogenomics2007 to Present

Notable progress has been made in

bioinformatics with the development of better

tools to aid life science research. The focus of

bioinformatics products is shifting from mere

development of databases to addressing

challenges of data deluge. Governments

have shifted their attention to reform

regulatory policies to fuel research in

bioinformatics.

In addition to the application of bio-IT in the lifesciences domain, it has gained prominence in the

field of healthcare management. The origin of health informatics dates back to 1950–60s; however,

the English term “Medical-informatics” was coined for the first time in a research paper, “Education

in Informatics of Health Personnel”, in 197428. In 1986, the National Library of Medicine (NLM), the

medical division of the National Institute of Health, developed the Unified Medical Language

Systems (UMLS) Metathesaurus, which enables storage, categorization and retrieval of biomedical

information. Currently, the system holds information on close to five million medical names and

one million biomedical concepts. This information aids in various clinical research activities, public

healthcare reporting, administrative and other research work.

28 Knowledge, Skills, and Resources for Pharmacy Informatics Education, by American Journal of

Pharmaceutical Education, 2011


19

Figure 8 : History of health-informatics in the global landscape


Primary focus on financial and

clerical activities. Large

computers were used and

basic management reports

were produced with low

flexibility for customised

reports. Various terms were

used to address the field in

France, Holland, Belgium and

Russia.

1974 1990s1986 2000to

Medical informatics as a term

introduced for the first time in

a research paper named

"Education in Informatics of

Health Personnel".

Development of Unified

Medical Language Systems

Metathesaurus that acts as a

vocabulary system facilitating

storage and retrieval of

biomedical information.

Full-fledged adoption with

various health care IT

initiatives formulated in order

to improve patient outcomes

and reduce errors through

well-designed decision

support applications.

Present

Applications of informatics

aimed at improving public

health.

1950-

60s

Despite the availability of NLM’s library set-up, the public health system witnessed few developments

in the initial few years. In the 90s, emphasis was laid on establishing an information infrastructure

alongside supporting health data standards in order to reach the masses. Also, public health

informatics (PHI) was launched during the same period. Thereafter (2000–as of date), high traction

was witnessed in the health informatics domain due to its application in handling large amount

of patient and research data, led by the growing understanding of human health. The rise in

specialisation increased the necessity to store, share and organise patient data. Also, with higher

internet penetration and availability of hardware (in the form of wireless systems and mobiles), the

adoption of health informatics tools and software became increasingly feasible.

Overview of the global bio-IT sector

The global landscape surrounding healthcare and biomedicine has been evolving at a tremendous

pace. Huge amount of data, much more than what can be physically stored, is generated through

the association between healthcare and medicine. With rising deluge of data, bio-IT’s role in

lifesciences and biological data management has gained increasing relevance. The post-genomic

era, flooded with biological data, has been availing the benefits of bio-IT, thereby supporting

scientific researchers in their analysis and interpretation. Over the years, IT infrastructure has

evolved to platforms (such as cloud computing) that ensure integration of data from a computer

cluster model used earlier. With the set-up, preservation and availability of open-access facility

for large datasets has facilitated the conception of novel techniques that assist in converting

information into knowledge.

Growth in bioinformatics fuelled by research and declining costs

The global bioinformatics industry has achieved significant growth, fuelled by rising applications

across various industries. The sector’s direct market size was estimated at USD2.3 billion as of

2012, implying a CAGR of 8.2% over 2005–1229. Industries such as bio-agriculture, biotechnology,

pharmaceutical research and analysis, and clinical diagnostics, along with favourable private and

29 Bioinformatics Market - Global Industry Size, Market Share, Trends, Analysis and Forecast, 2012–

2018, by Transparency Market Research, 2012


20

public initiatives, are the major growth drivers. The industry can play a major role in areas such as

drug designing R&D (USD149 billion by 201830), especially given the declining cost of genomics and

the advent of pharmacogenomics. The current market size is just the tip of an iceberg.

Decreasing cost of DNA sequencing, increasing funding from the government and private

organisations, and technological advancements in bioinformatics tools and platforms have propelled

the market. However, dearth of a common format for data integration, lack of well-defined standards,

and shortage of skilled bioinformatics professionals remain the key hurdles.

The Human Genome Project – a notable success

The global bioinformatics industry received an unprecedented boost from the Human Genome

Project (HGP). The US government initiated HGP in 1988, in collaboration with global partners:

the UK, France, Germany, Japan and China. The project was an international research effort to

determine the sequence of the human genome and identify genes that it contains.

The US government’s initiative achieved overwhelming success in 2000, when the project delivered

the first rough draft of the human genome sequence. The concluding final version was developed

in 2003, two years before schedule and within the allocated budget. Over the decade, economic

returns from the project have increased tremendously and currently hover around USD1 trillion. The

project was one of the most rewarding investments made by the government; a return of USD178

was realised for every dollar spent31.

Apart from financial returns, the project laid down a base for long-term goals focused on better

healthcare alongside noteworthy cumulative gains in the field of science and medicine. Since its

first success in 2000, the sequencing information generated from the project acted as a valuable

bridge for carrying out various research discoveries in lesser time. This can be justified by the

example of Huntington’s disease (1993), wherein tracking the gene took nearly 10 years. Similar

research now requires a few weeks as the time needed to track down rare disease genes was

reduced by a factor of 10 following the success of HGP32.

HGP boosted growth in the US’s genomic and proteomic segments, which play a key role in

innovation and developing newer drug designs and entities. Introduction of bioinformatics paved the

way for in-depth research in “-omics“, such as genomics, proteomics, and cheminformatics; system

biology and drug discovery, thus generating large amount of data that would need more effective

software, databases and tools. Therefore, it forms a virtuous cycle beneficial for economic growth

as well as the biotechnology and pharmaceutical sectors, and supports the bioinformatics industry.

Figure 9 : High returns generated from HGP

Source: Battelle data analysis and estimations; IMPLAN U.S. Economic Impact Models

4.3 million

>USD293 billion

USD1 trillionGovernment Investment

Personal income

Economic output

Jobs years of employ

-ment

30 EvaluatePharma’s World Preview, by Evaluate Pharma, 201331 Battelle Memorial Institute, 201332 http://www.xconomy.com/national/2013/10/03/human-genome-project-wasnt-overhyped-payoff-just-

took-time/


21

With the success of HGP, the bioinformatics industry has witnessed a revolution. The industry

transformed from a mere development of databases, sequencing, and biomarker studies to

undertaking in-depth analysis of a vast data pool. The shift is ascribed to rising demand across

genomics, proteomics, and molecular research, supported by newer technologies influencing

the methodology for research and diagnostic analysis. Furthermore, the industry has witnessed a

notable trend of outsourcing of bioinformatics services due to the cost-cutting initiatives undertaken

by several pharmaceutical firms for drug discovery. Bioinformatics techniques have revolutionised

the way research is conducted in the pharmaceuticals, agriculture, environment, energy and

biotechnology sectors.

Government bodies worldwide have played an important role in the overall progress of the global

bioinformatics sector. The US government encouraged the establishment of research institutions

and organisations to facilitate the long-term goal of USD1,000 project. Notable examples include

government-aided research organisations such as the National Institute of Health (NIH) and its

associated institutes in the US and the European Bioinformatics Institute (EBI) in the UK. In India,

the DBT, Department of Electronics and Information Technology (DeitY), Department of Science

and Technology (DST), and several others initiated and funded various projects to enable the

development of bioinformatics. Also, these global organisations offer various services, such as open

source databases and tools, to assist in lifesciences research and undertake training programmes

and courses to generate a skilled workforce.

In a bid to foster innovation in lifesciences with the aid of bioinformatics, many public institutes and

companies encourage the use of open source databases and tools. Bioinformatics Organisation

and Open Bioinformatics Foundation strongly favour the development and use of open source

software to cater to the scientific and educational needs of bioinformaticians. Open source

databases have brought about a revolution in the way research is conducted. Numerous efforts

have been made to establish networks connecting various databases at different locations. Also,

many software and analysis tools have been developed to aid studies across genomics, proteomics,

pharmacogenomics and cheminformatics. Some open source analysis software and database are

EMBOSS, Gaggle, Genepattern, CRDD, MetaPred, KetoDrug, KiDoq, GenGIS, IntAct and InterMine.

In terms of regional comparison in the global landscape, the US and Europe are considered to

be the key hubs for bio-IT. The US leads the market, enjoying a major share due to technological

advancements in bioinformatics tools and developments at the government and company level.

However, Europe, ranked second, is expected to outpace the US by 2018, with the UK and

Germany making maximum contributions to growth, mainly driven by government initiatives in

R&D33. The European bioinformatics market is becoming more consolidated as several companies

are jointly enhancing the quality of products, thereby fuelling growth. On the other hand, the

bioinformatics market in Asia-Pacific is still at a nascent stage. However, going forward, bio-IT in

India, Israel, and China is expected to expand considerably, with significant contribution from the

outsourcing business.

The global bioinformatics market has few large players enjoying a major market share and several

small ones contributing to a lesser extent. Of the total bioinformatics companies, the US accounts

for around 55%, followed by Europe (30%)34. Some major bioinformatics companies are Accelrys

Inc., Affymetrix Inc., Agilent Technologies, Celera Group, Gene Logic, Geneva Bioinformatics S.A,

IBM Life Sciences, ID Business Solutions Ltd., Instem Scientific Limited, Life Technologies Corp.,

Kinexus Bioinformatics Corp. and Nonlinear Dynamics Ltd. These companies offer integrated

solutions for genomics and proteomics, and tools for detection of biomarker patterns, data mining

and interpretation of mass spectrometry.

33 Bioinformatics Market – Global Industry Size, Market Share, Trends, Analysis and Forecast 2012 –

2018, by Transparency Market Research, 201234 Bioinformatics - A Global Strategic Business Report by Global Industry Analysts, March 2012


22

Evolution and growth of the health informatics industry

Healthcare administration and delivery has always required collection of information to ensure

best possible care. However, with time, new technologies, which could provide more precise and

diverse patient information, were developed. There was a notable change in the way information

was stored – from paper-based format to a fully computable form. With these rapid developments,

the new discipline of health informatics was formed. The industry has grown at a rapid pace, and

is pegged at USD40.4 billion35. Growth was projected to be driven by rising demand for affordable

healthcare services, faster and effective treatment, and the automation and synchronisation of

hospital workflow. Likewise, global governments are playing a key role in ensuring healthcare

companies adopt IT solutions (such as EMR) by issuing deadlines and penalising them

if they fail to do so.

Similar to bioinformatics, the health informatics segment has experienced rapid changes over the

years. It no longer works on the traditional model, wherein patients receive treatment on an episodic

basis. The industry has adopted a model, wherein disease prevention is considered as important

as treatment. This model is based on the issues encountered in everyday life, including those

arising from increasing healthcare needs and changing social environment. The health informatics

industry has expanded to include computers and data stored in them, all biological research and

development, and learning and medical practices. This has resulted in a new wave of research

prospects across eHealth and health literature.

Figure 10 : Evolution process of data storage


Non-electric data

Level4

Level 3

Level2

Level1

Unstructured, viewable electronic data

Structured viewable electronic data

The Computable electronic data

Geographically, the US and Europe have been early adopters of IT in hospitals and the public

health sector. North America (the US and Canada) has been the global leader, primarily driven by

government support in the form of grants and incentives. As early as in 1960, the NIH set up an

Advisory Committee on Computers in Research (ACCR) to facilitate seed funding to various leading

academic centres performing research in the field of health informatics. Asia-Pacific is expected to

pick up at a slower pace, with hospitals gradually turning towards IT to ensure better patient safety

and care. Meditech, Cerner Corporation, McKesson Corporation, Epic Systems, Allscripts, and GE,

along with Europe-based Siemens Healthcare and Philips, account for a major share of the global

health informatics market.

35 http://healthcaretechnologymagazine.com/HTM/index.php/en/healthcare-technology-it-news-

breaking/item/2853-healthcare-it-market-is-estimated-to-grow-at-a-cagr-of-7-0-to-reach-56-7-billion-by-

2017-from-40-4-billion-in-2012


23

Offerings and applications of the global bio-IT sector

Bioinformatics service offerings can be classified into: (i) content, which includes creation and

maintenance of databases; (ii) platform that comprises the development of analysis software and

tools; and (iii) infrastructure that refers to hardware and networking capabilities. The platform segment

accounted for the largest share (~50%) of the total bioinformatics revenue in 2012 and is expected to

register faster growth in the near term; also, it is likely to garner 54% share by 201836. Bioinformatics

infrastructure and content would continue to account for smaller portions of total revenue.

The most commonly used databases include GenBank and RefSeq (USA), EMBL (Europe) and

DDBJ (Japan). Furthermore, BLAST (basic local alignment tool), FASTA (DNA and protein sequence

alignment software that compares nucleotide or peptide sequences), EMBOSS (European molecular

biology open software suite), CLUSTALW (multiple sequence alignment programme for DNA or

proteins) and RasMol (display function for the structure of DNA), among others, are some of the

popular tools adopted worldwide.

Application of bioinformatics in lifesciences research includes genomics, proteomics,

chemoinformatics, molecular phylogenetics, metabolomics, transcriptomics, and others (glycomics,

cytomics, physiomics and interactomics). Of the various applications, genomics commands the

largest share. Interestingly, a significant share of bioinformatics services is used for the storage

and analysis of data generated from genomics and proteomics studies. For instance, more than

20% of the bioinformatics applications developed in the past five years were focused on genomics

and proteomics. In the coming years, the global genomics market is expected to gain momentum

with the development of newer technologies such as Next Generation Sequencing (NGS) and

application of genomics for developing personalised medicines.

The health informatics sector is classified into payer and provider (clinical information and non-clinical

information technologies) (based on applications); on-premises, web-premises, and cloud-premises

(based on delivery mode); and hardware, software, and services (based on the component type).

Some IT modules include Electronic Medical Records (EMR), Computerised Provider Order Entry

(CPOE), Clinical Decision Support System (CDSS), and Picture Archiving and Communication

Systems (PACS). These cater to healthcare providers (physicians, clinics, hospitals, and nursing

homes), payers (insurance companies), and consumers (patients). Furthermore, the field has

attained success in the public healthcare domain. Bioinformatics can help in catering to the major

requisite of public healthcare, i.e., efficient, reliable and widespread availability of services. The

health system delivery model has evolved significantly with the establishment of various national

initiatives based on electronic health records (EHR), data standards, and public health informatics.

In the field of health informatics, considerable emphasis has been placed on clinical issues such as

the design and implementation of EHR and decision support. However, health informatics also entails

medical ontology construction; information organisation, storage and retrieval; artificial intelligence;

text mining; data exchange & standards; natural language processing and security & privacy.

Bio-IT forecasts – How big is the global opportunity?

The global bioinformatics industry is poised for significant growth; the industry’s market size,

estimated at USD2.3 billion in 2012, is set to register a CAGR of 25.4% and reach USD9.1 billion during

2012–18. Growth would be led by end user markets: pharmaceutical, biotechnology, agriculture,

environment and forensic research, among others. Furthermore, the sector is likely to benefit from

the high-growth prospects in the genomics and proteomics markets; the global genomics market is

36 Bioinformatics Market – Global Industry Size, Market Share, Trends, Analysis and Forecast, 2012–

2018 by Transparency Market Research, November 2012


24

expected to grow more than 18% annually until 201737 , while the proteomics market is projected to

register a CAGR of 14.2% to USD17.2 billion during 2012–1738.

The global health informatics market is forecast to increase at a CAGR of 7% during 2012–1739

and reach USD56.7 billion. Growth is expected to be driven by increasing competition as well as

lower costs at hospitals and other facilities,, supporting the need for integrated healthcare systems.

Moreover, high returns on investment, following the adoption of healthcare systems, coupled with

government support could further propel growth. For instance, the foundation of ARRA by the US

government led to the phenomenal acceptance of IT in healthcare. In addition, developing countries

in Asia-Pacific are adopting IT in healthcare due to a rise in medical tourism, aging population and

chronic diseases.

Among the numerous IT services, EMR is one of the largest and fastest growing; it is expected to

expand at a CAGR of 7.5% during 2012–1640. Rapid growth could be ascribed to the rising need

for an advanced health monitoring model. The sector is also likely to benefit from high demand

for cloud computing services. The cloud computing market for healthcare is expected to register

a CAGR of 20.5% over 2012–1741. However, growth in cloud computing could be impacted by

issues related to security, interoperability and conformity with government regulations. Likewise,

CPOE is also expected to increase and reach USD1.5 billion by 2018, led by the need to reduce

medication errors42.

Non-clinical IT models such as telemedicine, mobile health, and digital health are emerging

areas under health informatics that deliver healthcare services at a patient’s doorstep. The global

telemedicine market is estimated to record a CAGR of 18.9% over 2012–1643. The market can be

categorised into tele-hospital or tele-clinic, and tele-home. Tele-hospital/-clinic provides access to

remote clinics through which patients in distant regions can speak to doctors in real-time, using

the internet. Tele-home includes service offerings such as symptoms examination, treatment

management, education and self-care support as well as resolving queries in a home set-up.

To capitalise on the high-growth outlook, various countries have devised strategies to strengthen

the bio-IT sector. Governments as well as leading institutions and industry players are actively

involved in the creation of an environment that facilitates bioinformatics research and boosts

intellectual and entrepreneurial expertise. However, the sector’s growth is highly underpinned by

the underlying cost component and unpredictable regulatory environment across developed and

developing nations.

37 Bioinformatics - A Global Market Overview by Industry Experts, March 201138 Proteomics Market - Instruments, Reagents & Services - Trends & Global Forecasts to 2017 by Markets

and Markets, October 201239 Report by Markets and markets, May 201340 Global Hospital-based EMR Market 2012-2016 by TechNavio, August 201341 Healthcare Cloud Computing Market, by MarketsandMarkets, 201242 http://www.fiercehealthit.com/story/computerized-physician-order-entry-cpoe-market-projection-15-

billion-2018/2012-07-1643 TechNovio Forecast, 2013


25

Bio-IT sector’s contribution to global healthcare

Bio-IT has played a remarkable role in the development of lifesciences. With a rise in the amount of data originating from patients and researchers, the application of bio-IT tools and software has increased manifold. Bio-IT has significantly contributed to the integration, research and analysis of a vast data ranging from gene sequences, laboratory tests and imaging in the bioinformatics segment to medical records, treatment histories and survey data in the health informatics space. With advancements in molecular and synthetic biology, and breakthroughs in hardware tools, the sector has transformed the way research is conducted today—from a hypothesis-driven based on trial and error methodology to data-driven one based on focused methodology. Furthermore, global healthcare has highly benefited from the rational drug designing process facilitated by the use of bio-IT. The sector has also proved instrumental in the progress of the newly introduced domain of pharmacogenomics.


26

Bioinformatics competence in handling biological data deluge

Significant progress in bioinformatics has aided advancements in genomics, proteomics, and

translational bioinformatics, thereby leading to the development in healthcare. Advancements in

high-throughput data acquiring techniques, such as NGS, along with the progress in digital storage,

computing, and information technologies over the past few years has begun to transmute biology

from a data-poor science into a data-rich one. Consequently, DNA sequence databases have

doubled up in size every 12 months, and the identification and archiving of 49 million mutations

or single nucleotide polymorphisms has been made possible. Apart from their application in

sequencing, high-throughput techniques generate a large amount of data when used for mass

spectrometry and compound screening experiments. Challenges pertaining to the storage, retrieval,

analysis and interpretation of this large biological data can be addressed through bioinformatics.

Previously, a single gene, protein or signalling pathway was sufficient to analyse a disease.

However, with the advent of bioinformatics, it is feasible to analyse a disease at each level of

complexity, from a genomic DNA to RNA to proteins. Bioinformatics also supports the analysis of

various modifications occurring at the RNA and protein levels.

Figure 11 : Bioinformatics support every stage of “-omics” used in diagnostics


Phenotype

Transcription

Translation

Cellular Processing

Enzymatic Reactions

Genome

Transcriptome

Proteome

Metabolome

Genes

mRNAs

Proteins

Metabolite

Genomics

Genomics, which involves analysis of a complex set of genes, their expressions and role played

in biology, has gained momentum over the past few decades, driven by rising availability of

sequencing technologies. This has led to the creation of a vast amount of data that needs to

be managed and retrieved. The biggest application of bioinformatics in genomics is HGP, which

involved sequencing of more than 30,000 genes in a DNA. The project helped in understanding

various inter-relations and functions of these genes. Moreover, this genomic information played a

pivotal role in diagnosing human diseases and discovering new approaches for gene-based drug

discovery and development. Over the years, drugs targeting various diseases were discovered


27

using computational biology, leading to a more efficient and less time-consuming process and

further emphasising the role of bioinformatics.

A decrease in the cost of genome sequencing has substantially added to the advantages of

adopting bioinformatics. Since the successful completion of the global HGP in 2003, the cost of

genome sequencing has declined rapidly. The discovery of the first human genome took nearly 13

years of intensive work from numerous worldwide institutes and hundreds of scientists, and cost

around USD3 billion. With the advent of NextGen DNA sequencing expertise, the cost of sequencing

fell significantly to just over USD5,000 as of October 2013 from USD95 million as of 2001. Also,

the process can be completed in one week with the help of one machine. Likewise, the cost of

DNA sequencing also plummeted from over USD5,200/megabytes (Mb) in 2001 to USD0.06/Mb

in October 201344. Success in the effective use of bioinformatics paved the way for the impossible

USD1,000 genome project in 2005. Completion of this project would mark the beginning of a new

era of predictive and personalised medicine, wherein the cost of full genome sequencing of an

individual would decline to nearly USD1,000. The National Human Genome Research Institute has

allocated significant amount of funds and is making tremendous efforts to achieve the lofty target.

Figure 12 : Sharp fall in the cost of DNA sequencing (USD/Mb) and genome (USD mn)

Source: National Human Genome Research Institute

0

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Cost per Genome Cost per Mb of DNA sequence - RHS

Transcriptiomics

Transcriptiomics, also known as expression profiling, is a study based on the expression level

analysis of Messenger RNA (mRNA), with the support of DNA microarray technology. Bioinformatics

tools aid in analysing transcriptome, giving details about biological processes at each moment in

time. Bioinformatics tools and software aid in RNA-Sequencing, from profiling a simple mRNA to

the entire discovery and analysis of the transcriptome. RNA-Seq has significant application in next-

generation sequencing platforms as it helps in uncovering any information that may be overlooked

in array-based platforms.

Traditionally, owing to cost constraints, RNA-Seq was applied for discovery-based applications

such as unusual genes, splice junctions, gene fusions and along with new or weakly researched

organisms. However, with technological advancements leading to cost reduction, it has gained

ground in RNA profiling as well. Furthermore, RNA-Seq helps in carrying out RNA editing and allele-

specific expression analysis. With the NGS expertise presenting advanced analysis and throughput

techniques, single cell transcriptomics supports studies in sub-populations having tumours,

distinguished embryonic stem cells and bacteria in a biofilm, among others.

44 National Human Genome Research Institute


28

Proteomics

Proteomics is another fast-growing domain in the lifesciences industry, supported by and, in

turn, fuelling the informatics sector in India. It deals with analysing the functions and structures

of and the interplay among proteins generated from the gene of each cell, tissue and organism.

Involvement of technology, i.e., bioinformatics, is inevitable due to the importance of proteomics

study, which can support disease discovery. Bioinformatics would aid proteomics researchers in the

areas of preventive and personalised medication that would lead to faster treatment of diseases

in the long run.

With the support of bioinformatics, efficient algorithms are being implemented, facilitating the

management of large and diverse data sets. Moreover, elaboration and integration of this

data is made feasible. Technological advancements have enabled quantifying roughly 10,000

proteins from diverse genes in human cell lines45. Considering the rising complexity associated

with the substantial data generated from each experiment, the role of bioinformatics becomes

increasingly important.

So far, algorithms focusing on image analysis of 2D gels and data analysis targeting peptide mass

fingerprinting and peptide fragmentation fingerprinting in the mass spectroscopy domain have

been formulated. Factors such as rising demand for proteomics-related software and its widespread

application in the healthcare sector have supported bioinformatics companies developing various

products. These products have facilitated the understanding of a range of molecular pathways

such as disease states (like cancer), diagnostic protein biomarkers, protein-protein interaction,

protein sequencing and protein purification. This, in turn, has led to the generation of more effective

procedures for biomarker development and protein targeting with therapeutic agents.

Metabolomics

Metabolomics, initially perceived as a technique of functional genomics, is today used for diverse

purposes such as comparing mutants, assessing responses to environmental stress, studying global

effects of genetic manipulation, comparing different growth stages, toxicology, drug discovery,

nutrition, cancer, diabetes and natural product discovery.

The process of metabolomics, based on in-depth analysis of cellular metabolites, produces huge

quantity of data. Specific statistical, computational and bioinformatics tools are required to manage,

dispense and examine this data. Bioinformatics applications range from information management,

basic data processing and analysing metabolomics standards & ontology to numerical analysis,

data mining & integration, and modelling of metabolic networks.

Information management in hospitals using medical informatics

The healthcare sector has significantly benefited from health informatics, the field dealing with

the management and use of information in hospitals. Bio-IT not only aids the biological data

handling process but also facilitates efficient administration and management of data involved in

medical tests, clinical trials, laboratory and inventory, to name a few. Adoption of IT services in

hospitals has led to drastic changes in global administration processes and proved beneficial for

healthcare professionals in terms of saving time and cost. The shortcomings associated with paper-

based records and partially computerised systems (such as duplication, difficulty in retrieval, and

misplacement of records) are eliminated.

45 http://www.clinicalproteomicsjournal.com/content/9/1/6


29

Figure 13 : Integration of information technology with hospital management systems


Hospital management

using information technology

Front office MGT

Outpatient MGT

Inpatient MGT

Radiology information

system

Electronic medical records

Clinical decision support system

Pharmacy MGT

General inventory control system

Lab information

system

Asset MGT and tracking

Financial MGT system

The integration of various departments with the aid of IT improves service delivery and inhibits

resource deficiency, leading to a fall in consulting time and prevention of wrong prescription. Tools

such as CPOE and CDSS offer clinical alerts and precautions to physicians, thus minimising errors

during ordering and prescription of drugs. Adoption of CPOE has reduced total medication errors

by 80% and serious medication errors (serious toxicity to a patient) by 55%46. In addition, CPOE

has been integrated with the laboratory, pharmacy and radiology departments in the same or

other hospitals, enabling data sharing from a single point, to ensure faster treatment, refer critical

cases and reduce repetition of diagnostic tests. Similarly, tools such as PACS have assisted in the

collection of various diagnostic images from X-ray, MRI, and CT-scan conducted in laboratories

across different points and their integration into a single medical record or repository. Various

insurance companies and clinical organisations have started using integrated patient data to their

advantage. This data also supports clinical researchers and academic institutions in the research of

disease patterns while designing new therapeutic modalities. Furthermore, insurance companies

can carefully study the disease trends to design insurance policies and retrieve patient records with

ease before refunding the money spent on treatment.

Rendering the drug discovery process efficient and cost-effective

Issues arising in the process of drug design and development are gradually being resolved through

46 http://www.micann.com/med_it.htm


30

the adoption of bioinformatics. The conventional drug discovery and development process is

exposed to a high gestation period, complexity and associated costs. Also, the key reason for low

expenditure on R&D is the cost associated with the complete drug development process, from

target identification to market launch. The process involves 12–15 years, with an associated cost

of USD1.5 billion per drug47. As the drug moves from the development stage to pre-clinical and

clinical stages, associated costs and risks increase due to the high possibility of adverse outcomes

of toxicity studies and pharmacokinetics or absorption/distribution/metabolism/excretion (ADME),

which indicate how the body reacts to a specific drug after administration.

Figure 14 : Time required for conventional drug discovery (~14 years)


Target Discovery Lead Generation and Lead

Optimisation

Precilinical and Clinical Trials

FDA Review and Approval

Drug to the Market

2.5 years

3 years

7 years

1.5 years

Adoption of bioinformatics accelerates the entire drug discovery process by reducing the overall

time and cost. It even leads to higher success rates. Tools, databases and software can aid the drug

discovery process at every stage, from target identification and lead finding to lead optimisation and

pre-clinical testing. The foremost issue with target identification/discovery from millions of possible

targets has been simplified by enabling detection of targets having higher potential for a new drug.

Moreover, with the help of bioinformatics tools, a larger number of biological targets can be sampled,

thus increasing the probability of the drug being developed. Later in the process, target validation is

also made easier by strategies and algorithms that help in establishing strong correlation between

the potential targets and disease of interest, thereby reducing the odds of failure during clinical

testing, the next step. When the drug reaches this phase, the major issue limiting its progress is

the high cost related to the many stages of clinical trials. With the available tools and software, this

cost has also been moderated. Further in the process, pharmaceutical companies have to bear

the costs related to approvals, litigations and commercialisation. The cost of commercialisation is

as high as USD250 million per new drug. Considering the high cost involved in developing a new

drug, the global healthcare sector has benefited immensely from bioinformatics tools and software.

For instance, the application of in silico methods in drug discovery has lowered the time taken to

develop a drug by 2–3 years and cost by more than 50%48.

47 http://www.sciencebasedmedicine.org/what-does-a-new-drug-cost-part-ii-the-productivity-problem/48 Drug Design Bioinformatics by Inserm


31

Figure 15 : Integration of bioinformatics to aid drug discovery at various stages

Source: Cheminformatics in drug discovery by IGNOU, Christ College, NCC INDIA

1

2

3

Target Identification

Genomics

Proteomics

Lead Finding

Lead Optimization

Pathway Anaylsis

System Biology

Pre-clinical Studies

4

Molecular Databases

Combinational

Chemistry

High Throughput

Screening

Virtual Screening

Structure Activity Relationship

Insilicon ADME

Toxicity Alerting

Bio-isosteric Design

Virtual Human and Animal Models

Separately, cheminformatics, the convergence of IT and synthetic chemistry in the drug development

process, encompasses both chemical and biological analyses. It aids a rational drug design process

vis-à-vis the one based on trial and error.


33

Bio-IT: The Indian landscape

Though the foundation of India’s bio-IT sector was laid in the early 1960s, the real impetus was seen during 1986-87, when BTIS was launched. The sector received another boost with India joining the league of the US, the UK, Canada, China and Korea by successfully completing the Human Genome Project in late 2000s. Despite its smaller contributions to India’s biotechnology sector, bioinformatics has been growing at a robust pace – a CAGR of 12.8% to USD55.0 million over 2007–13. Domestic factors such as abundance of skilled human resources, spill over from pharmaceutical and biotechnology growth and the country’s biodiversity combined with outsourcing demand has supported the sector’s development.

Also, the health informatics sector has received funding across both private and public initiatives, with new inclusive healthcare models such as telemedicine gaining utmost precedence. The Indian government in association with various industry players have launched several programmes with an objective to offer preventive and primary healthcare services to the rural India. The health informatics sector will continue to benefit from the changing scenario of India’s healthcare delivery model. The bio-IT sector is expected to remain on an uptrend and reach USD10.2 billion by 2025; of this, the bioinformatics sector is expected to contribute USD2.7 billion with health informatics constituting the remaining.


34

Origin and history of bio-IT in India

Origin and history of bioinformatics in India

The foundation of bioinformatics in India dates back to the 1960s, when for the first time Prof. G. N.

Ramachandran, along with his colleagues C. Ramakrishnan and V. Sasisekharan, developed the

famous Ramachandran diagram. Thereafter, during the 1970s and early 1980s, the industry’s growth

slowed down due to an import ban on world-class computer technology. During this period, the

industry advanced to a certain extent with the success of structural analysis of protein carried out by

the DBT, Government of India, in 1986–87. This was a decade before the term “bioinformatics” was

coined. During the same period, the department launched the “Biotechnology Information System

Network (BTISnet)”, offering a network connecting major domestic research institutions. The initiative

proved successful and currently has more than 150 research institutions catering to the simulation

platforms and training needs of the industry. These efforts resulted in other research discoveries,

policy formulations and inception of national & local institutions, among others, thus transforming

bioinformatics into a full-fledged scientific discipline of knowledge discovery.

Figure 16 : History of bioinformatics in the Indian landscape


1960s

Foundation laid by Prof. G. N.

Ramachandran with the development of

Ramachandran plot in 1963.

1990s

Active period, during which basic

infrastructure and trained personnel with

requisites skills were developed by the

DBT.

1980s

Sector slowly picking up pace; Success

of structural analysis of a protein;

Launch of BTISnet

1970s

Bioinformatics industry’s growth was

restrained by a ban on exports of world

class computer technology to India.

2000s

Bioinformatics Policy of India (BPI–2004)

was formulated to ascertain India’s

competitiveness in the global scenario.Present

Bioinformatics is fully developed in India,

with its applications ranging from simple

analysis of gene/protein to complex

analysis in system biology.

Origin and history of medical informatics in India

In contrast to other developed nations, India was comparatively a laggard in the adoption of IT to

tackle the bottlenecks in the healthcare sector. Medical informatics gained prominence for the first

time in the 1980s with NHP emphasising the potential IT holds in ensuring affordable and accessible

healthcare services.

Some other prominent developments were the establishment of Indian Association for Medical

Informatics (IAMI), a professional association, in 1993 to capitalise on the benefits of medical

informatics. With IAMI’s support, digitisation of medical libraries, databases and medical interaction

was made possible. Moreover, computer literacy campaigns and e-learning were undertaken to

support growth in the sector.

Substantial advancements were witnessed in the field of medical informatics during the late 2000s

vis-à-vis the 1990s. The Expert Committee on Standards for Electronic Medical Records (2010),

set up by the Ministry of Health and Family Welfare (MoHFW), Government of India, necessitated

the introduction of EHR concepts, mobile health, and other related subjects and protocols in

conventional healthcare certified education.


35

Overview of the Bio-IT sector in India

The bio-IT sector is still at a nascent stage. Individuation of the sector commenced in the late 1980s

with the launch of BTISnet, under which, a nation-wide network of Distributed Information Centres

(DICs) was set up. India, with its IT expertise alongside a cost competitive environment, gradually

entered the universal bio-IT space by assisting global pharmaceutical giants. The ripple effect has

been evident in recent years, with a notable uptrend in terms of new firms, improved product

pipelines, rising patent applications, and a number of products entering the market. On similar lines,

the health informatics field also witnessed a revolution with major technological advancements

transforming the way healthcare is being delivered.

Double-digit growth in the bioinformatics sector

Bioinformatics is a promising and lucrative field in India’s biotechnology sector. Although at a

nascent stage, it is considered one of the fastest-growing fields. Despite its meagre contribution of

nearly 2% to the overall biotech industry, the bioinformatics market is projected to register robust

growth. The sector expanded 12.4% y-o-y and was pegged at INR2,990 million (USD51.2 million)

as per 2012–13 statistics. The figures reflect growth continues to remain positive after decelerating

marginally during 2011–12. The bioinformatics sector registered a CAGR of 12.8% during 2006–13.

The double-digit growth was fuelled by the establishment of a strong linkage between IT and

biotechnology, brought about by the success of HGP in India (concluded in 2009).

Factors such as a vast pool of skilled human resources, growth in the pharmaceutical and

biotechnology sectors, and the country’s biodiversity have aided growth in the bioinformatics sector.

Outsourcing of bioinformatics services to India has acted as a catalyst for the sector’s development.

Also, a leading position in the global software space and rising biotechnology proficiencies has

provided India several benefits in addressing the challenges faced by the bioinformatics industry.

Figure 17 : Rising revenue from bioinformatics (INR bn)

Source: ABLE

1.5

1.92.2 2.3

2.52.7

3.0

2006-07 2007-08 2008-09 2009-10 2010-11 2011-12 2012-13

CAGR 12.8%

Shift in revenue composition

Prior to 2009–10, the Indian bioinformatics industry was primarily driven by exports. However, over

the years, the trend has shifted and the sector has undergone transition from an export-driven

revenue stream. An increase in domestic revenues (214% y-o-y growth in 2009–10) sustained the

sector during the global economic recession.

During 2012–13, domestic operations accounted for 62% of revenues in the bioinformatics sector

vis-à-vis 21% in 2007–08. Though bioinformatics exports rose 32.9% y-o-y to INR1.13 billion (USD19.3

million) in 2012–13, it was down from the high of INR1.7 billion (USD29.1 million) witnessed in 2008–

09. Services and tools account for a majority share in bioinformatics exports. The major reason

is that global drug developers considered India as a low-cost destination for outsourcing their

research and manufacturing work.


36

Figure 18 : Trend showcasing move towards a balanced revenue stream

Source: ABLE

83% 79% 77%

32%42%

32% 38%

17% 21% 23%

68%58%

68% 62%

2006-07 2007-08 2008-09 2009-10 2010-11 2011-12 2012-13

Exports Domestic

Human Genome Project

India was among the forerunners in the genomics space. The country entered the league of the US,

the UK, Canada, China and Korea by successfully completing the Human Genome Project in 2009.

A team of scientists at the Institute of Genomics and Integrative Biology (IGIB) in Delhi, under the

spectrum of CSIR, decoded the genome sequencing of an Indian citizen. This was a spectacular

leap paving the way for delivery of low-cost healthcare to the population. This breakthrough also

set the groundwork for research in predictive healthcare, enabling the possibility of finding out

reasons for the failure of certain treatments for a particular set of population. It can also help in

analysing what kind of diseases a certain family is more likely to develop.

HGP was successfully concluded in 2003 (in around six weeks). The initial set up for the project—

establishing a supercomputer facility, obtaining software and streamlining protocols—took

nearly two years.

India moving towards garnering full potential of medical informatics

Bio-IT application in hospitals and public healthcare systems falls under the ambit of health informatics.

The industry is undergoing a revolution with a rise in adoption of IT tools and applications. It is

constantly evolving with the introduction of innovative models such as telemedicine, mobile health

and medical tourism to boost healthcare efficiency on the whole. Embracing IT in the healthcare

field has been the utmost precedence for companies. Nevertheless, information management in

Indian hospitals, especially public hospitals, is inadequate. With the admittance of a patient, a pool

of information, including name, age, birth date, inpatient and outpatient details, financial details,

lab reports, etc. is generated. Most hospitals in India maintain these records using either a paper-

based system or a partially computerised one. In case of the latter, entries are done by physicians,

nurses, pharmacists and accountants at different times of the patient’s stay using one of the several

computers in a local area network.

The shortcomings of practicing paper-based records/partially computerised systems are

duplication, difficulty in retrieval, and misplacement of records. Only 18% of Indian hospitals

have adopted EMR, while the rest still maintain paper records. Hospitals spend about 5–10%

of their gross revenue on IT, whereas their western counterparts have an IT budget of 40%49.

Among the 16,000 hospitals in India, just a few public hospitals such as Tata Memorial Hospital,

Christian Medical College (CMC) Hospital and AIIMS, and private hospitals (such as Fortis,

Apollo, Wockhardt and Max Healthcare) have completely implemented computational methods

for hospital management. This scenario was expected to change with healthcare providers

49 http://modernmedicare.co.in/articles/it-in-healthcare-welcome-to-the-world-of-opportunities/


37

anticipated to spend USD1.05 billion on IT products and services in 201350. Consequently, there

has been an increase in the number of IT players entering the market. Moreover, with the advent

of new healthcare models such as telemedicine and e-prescriptions, investments in IT in hospitals

is expected to rise significantly, with emphasis on billing systems and integrating & collating

patient details of various hospitals online.

Hospitals lack integration between the physician and pharmacist, or the lab technicians and doctors.

Lack of knowledge about the patient, family history, and drug allergies heighten the risk of faulty

diagnosis, wrong prescriptions, ordering errors, and adverse drug reactions. As per a research, in

India, there are 20.7 ordering errors per 1,000 orders, of which 1% resulted in adverse drug reaction

(ADR) and 10% in potential ADR.

Various programmes have been launched to combat the challenges and improve overall healthcare

administration. For instance, “Nikshay”, launched by the Central TB division in co-operation with NIC

in May 2012, is an internet-based record portal for TB patients. A total of 1.25 million TB cases have

been recorded as of date on Nikshay. This platform offers timely reminders for medication and

check-ups to registered patients and aims to record all of the TB cases across private and public

hospitals in India by 2015. This would not only help in building and monitoring a database of TB

patients but also assist in decoding any association between TB and other diseases, such as HIV,

which may give a new course to the current treatment.

Southern India housing big league bio–IT companies

Several Indian states are vying for a share in the bio-IT market; however, encouraging private players

to set up base has been particularly successful in Karnataka, Andhra Pradesh, Kerala and Tamil Nadu.

Southern India, with the largest bio-cluster/bio-parks, has established itself as India’s leading IT, ITeS

and biotech hub. Some of the apex ones include ICICI Knowledge Park (genome valley), Shapoorji

Pallonji Biotech Park, Bangalore Biotech Park and TICEL Bio Park Ltd. Moreover, the foundation laid

down by Alexandria Real Estate Equities Inc. to build Bengaluru Helix, a Biotech Knowledge Park

in Bangalore in 2011 (at a cost of INR55 billion (USD941.6 million)) is a case in point. The project is

scheduled to commence operations by the end of 201451. Other cities having bio-IT hubs in India are

Pune, Mumbai and Hyderabad.

India has more than 200 bioinformatics-related companies and over 300 educational institutions

providing bio-IT courses. Apart from pure play bioinformatics companies, IT companies have also

set up dedicated practices in this field. Bioinformatics and lifescience firms have core competencies

of discovery informatics, with specialised offerings in data mining and visualisation, and databases.

IT companies have larger product and services portfolios, which may include clinical trial informatics

coupled with capabilities in data mining, visualisation, integration tools and databases.

Leading bioinformatics enterprises in India include Strand Life Sciences, Ocimum Biosolutions,

SysArris, SciNova India, CytoGenomics, Mascon Life Sciences and Molecular Connections. Major IT

giants such as Wipro, Tata Consultancy Services, Cognizant, and Infosys have incorporated distinct

divisions catering to the lifesciences domain within their organisations.

Evolving climate of bio-IT in India

With the notable revolution in IT, Indian markets have also progressed in the allied bio-IT space.

Significant R&D has been undertaken in this field. Rising awareness of various mechanisms has helped

in unearthing the wealth of data existing across several organisms. As India is a developing country,

50 http://www.healthcareglobal.com/finance_insurance/india-healthcare-it-spending-to-hit-105bn-

in-201351 http://www.business-standard.com/article/companies/alexandria-to-invest-rs-500-cr-on-bt-

park-111071200048_1.html


38

bioinformatics has specifically played a major role in areas such as agriculture, pharmaceuticals

and biotechnology. Bio–IT applications range from research for pest-resistant and water-stressed

crop performed for the agricultural set up to enhancing the efficiency of drug discovery for the

pharmaceutical sector. Furthermore, the sector has made major inroads in fighting third world

diseases, such as malaria and TB, prevalent among the Indian population. A national database

on tuberculosis has been jointly developed and executed by institutes and organisations such as

National Jalma Institute Leprosy and Other Mycobacterial Disease (NJIL&OMID) (Agra) and Maulana

Azad National Institute of Technology (MANIT) (Bhopal), with inputs from National Tuberculosis

Institute (Bengaluru), IOB (Bengaluru), JNU (New Delhi), IISC (Bengaluru) and Tuberculosis Research

Centre (TRC) (Chennai).

Research on genomics and proteomics has gradually shifted from examination of an individual

constituent of life to a whole biological entity. In-depth study of the whole organism has emerged,

supported by a seamless combination of molecular, cellular, developmental, computational and

physiological sciences. India’s bioinformatics industry has evolved from just gene sequencing to

functional genomics, bio-molecular structures, proteome study, cell metabolism, biodiversity and

chemical processing, among others. Areas such as contract research and development services,

clinical trials, contract manufacturing and drug development have witnessed maximum investments,

research and growth. Some well-known bioinformatics software developed in India include Gene

spring X, Sarchitect, Biologo and web-chemistry by Strand Genomics. Furthermore, Strand Life

Sciences recently collaborated with US-based El Camino Hospital to establish a genomics and

pharmacogenomics centre in San Francisco.

The adoption of IT in healthcare administration has witnessed paradigm shifts. Various hospitals

have shifted from using IT for back office and clinical applications to state-of-the-art devices and

electronic medical records. These technological advancements are required for domestic players

to build scalability, eliminate redundancy and remain globally pertinent. Also, the rising trend in

insurance penetration has led to a rapid increase in demand for EMR. The technological wave has

slowly gained acceptance in Tier-II cities. With growing focus on hospital information systems (HIS),

the hospital instruments market now also comprises products for administration, EMR, pharmacy,

workflow management, security, biometrics, drug databases and PACS, among others.

The use of IT has helped in reaching out to millions residing in rural India. The Rural Effective Affordable

Comprehensive Healthcare (REACH) project, launched by Science Health Allied Research Education

(SHARE) India, is a successful example of harnessing IT for better service delivery. The programme

aims to provide preventive and primary healthcare services to the rural populace. It entails tracking

of demographics, health, and medical records of each household. The project led to immunisation

coverage of 93% and retained the total fertility rate below the replacement levels.

Furthermore, cloud platform has changed the way IT is used in healthcare. It has enabled all of the

stakeholders in the healthcare process to access the information. Seamless management and access

to EHRs of patients has been made possible, ensuring access to healthcare products and services

for patients in remote locations and to those having limited access to quality medical treatments.

India’s bio-IT sector to witness increased domestic and global demand

India is envisaged to become one of the notable contributors to the global bio-IT demand and

develop into a global hub for bio-IT tools and services. The country’s success story in the IT

landscape, coupled with adequate biotechnology expertise, gives it an edge over peers. A major

differentiating factor would be the low-cost structure. Though employee costs have increased in

India over the years, it still remains one of the most attractive destinations due to the blend of low-

cost and high quality. The cost component is supported by access to highly qualified engineers and

scientists. Internationally-renowned elite educational institutions provide a constant supply of skilled

workforce. This, coupled with the English- speaking capabilities of India’s young populace, is an

important factor driving the country’s contribution to the global bio-IT landscape. Furthermore, India

is considered a preferred choice for global pharmaceutical companies. On the whole, competency


39

in research and innovative solutions, along with the location advantage, has the potential to fuel

growth in India’s bioinformatics sector.

India’s large pool of skilled workforce

Proven track record in iT

The long-existing IT expertise enjoyed by India has been a significant contributor to the burgeoning

bio-IT market. To capitalise on the government’s increasing focus on modernising the healthcare

sector, several IT companies, such as TCS, Infosys, and Wipro, have added a separate lifescience

domain in their portfolio. These companies demonstrate core competence in the areas of

proteomics, genomics, drug discovery, data analysis services, and scientific data management

systems, with the aid of well-developed bio-IT tools and software. Moreover, India’s IT advantage

has played a key role in attracting bio-IT business from overseas.

skilled workforce in iT and lifesciences

One of the key factors driving the bio-IT business in India is a large workforce proficient in IT

and biotechnology. Most core bio-IT companies today have been set up by the alumni of premier

institutes such as IITs and IISc. Also, the five academic Centres of Excellence (CoE) serve as a

prominent source of qualified professionals. In addition, India has a high number of molecular

biologists and statisticians. With more than 0.5 million science graduates and 4,000 doctorates in

the fields of life and health sciences, India accounts for 10% of the global skilled workforce having

expertise in IT and biotechnology.

India’s research expertise is obtainable at a lower cost compared to professionals from western

countries, thus reducing the overall research cost. Interestingly, in terms of skilled human resource

and availability, India has a score of 2.76, much higher than its competitors such as China (2.55) and

advanced European counterparts such as Germany (2.17), France (2.12) and the UK (2.26). Also, the

cost of establishing and operating a bioinformatics firm in India is very low vis-à-vis the US. These

factors assist the bioinformatics sector’s goal to be a part of the global bio-IT potential.

Figure 19 : India – Second most attractive destination globally for people skills and availability

Source: AT Kearney location index 2011

0.0

0.5

1.0

1.5

2.0

2.5

3.0

India China UK Germany France Brazil

skills nurtured by training programmes

Various institutions and state universities have introduced specialised bioinformatics courses in

their post-graduate biotechnology programmes due to its widening scope. For instance, DBT offers

an advanced diploma in bioinformatics at its universities across Madurai, Pune, New Delhi, Kolkata

and Puducherry. Also, the Ministry of Science & Technology has built a national facility at IIT Delhi,

focused on the in silico drug development process based on bioinformatics. With these specialised

courses, Indians have developed the pre-requisites for performing data handling, data mining,

genotyping, fingerprinting and next-generation sequencing, among others.


40

India among the preferred CRO and CTO locations for drug development

Of India’s total bioinformatics revenue, outsourcing activities account for a major share. In the era

of an economic slowdown, CRO and CTO are important sources of revenue for pharmaceutical

giants, and a growth opportunity for India’s bio-IT sector. The country is well positioned with intrinsic

benefits such as high-quality, low-cost R&D and cheap availability of knowledge resources. As

part of CRO and CTO, major activities involve pre-clinical phases in a drug discovery process and

clinical trials. In addition, to counterbalance patent expiries and dwindling product pipelines, foreign

pharmaceutical companies seek to outsource bio-IT services for drug discovery.

Notably, global pharmaceutical companies outsource a large percentage of their high-end services

such as clinical trials (35%) and drug discovery (25%)52. Outsourcing is expected to increase further as

companies aim to counter high drug development costs. In the drug development process, clinical

trials and drug discovery account for 62% and 26% of the entire drug development expenditure,

respectively. Figures suggest outsourcing of the clinical trials and drug discovery businesses to

India, relative to other developed countries, reduces the overall cost by 30–40%, while outsourcing

core bioinformatics services leads to cost savings of up to 60%53.

India, with its advantages, is set to grow aggressively and acquire a larger share in the global

bioinformatics market in the coming years. However, at the same time, the IPR regime, government

support and public-private collaborative initiatives would remain key focus areas

52 India, China most preferred CRAMS destinations by Pharmabiz.com, 10 May 201253 Indian Bioinformatics Market Forecast to 2015 by RNCOS, August 2012


41

Bio-IT Meeting India’s Healthcare Needs

Bio-IT is becoming increasingly relevant in addressing India’s healthcare needs. The field assists the back-end drug discovery process through bioinformatics and supports optimal decision making, delivery and management through health informatics. Rising volumes of structured databases, software algorithms and tools form the crux of the entire informatics domain. Offerings that span various levels of complexity in hardware set-up; customised software products; and database packages with enhanced functionality have played an instrumental role in enhancing India’s healthcare system. The government’s efforts, coupled with increased activity among pure play and IT companies, have also supported the progress.

Emphasizing the need for a national public health information infrastructure, which enables efficient storage, distribution and delivery of healthcare services, the MoHFW, Ministry of Communication & Information Technology (MCIT) and several state governments started working towards public health informatics (PHI). While the government is focusing on bridging the healthcare infrastructure deficit faced by the underserved population, private players aim to revolutionise the way healthcare is delivered and managed currently. However, the extent of the electronic healthcare delivery mechanism has not been as developed in India, considering its size. It is majorly restricted to digital prescriptions, telemedicine, HMIS and health awareness programmes.


42

Aiding India’s ambitions in developing medicines

The Indian bio-IT space has witnessed tremendous progress with regard to the number of

databases and software developed over the past decade. These tools have led to quicker and in-

depth revelations, aiding in the development of new drugs. Recognizing this informatics revolution

led by bio-IT, DBT established BTISnet, which supports various user communities in their drug

research activities with a collection of online databases. The network has also mirrored international

databases such as EMBL, EBI, PDB, and GDB. In addition, the commercially available chemical,

proteins and genome databases assist the discovery process by ensuring faster virtual screening.

In recent times, drug repositioning, i.e., discovering new drugs based on existing molecules

by analysing new application areas, is gaining traction. For instance, Hyderabad-based GVK

Biosciences entered into an agreement with US FDA for collaboration in drug repositioning by

licensing its popular SAR, PK and Toxicity databases to the latter in 2013. The Material Transfer

collaboration primarily aims to search substitute therapeutic treatments of commercialised drugs

for various ignored and orphan diseases. The alliance would make use of data from the former’s

proprietary database GVK BIO Online Structure Activity Relationship Database (GOSTAR). The

decade-long GOSTAR was created by 200 scientists and includes 6.3 million compounds and 16+

million quantitative SAR points from nearly 2.5 million patents and 400,000 journals with a total

coverage of biological and chemical data points54.

Developing personalised drugs (pharmacogenomics), an outcome of the combined knowledge

of genomics, pharmacology, and bioinformatics, has significant application in India’s genetically

diverse population. With increasing awareness about the advantages of customised medicines

among healthcare professionals, large pools of patients are now encouraged to undergo genetic

analysis before necessary therapy is designed for them. By understanding the role of specific genes

in ADME, the drug or drug combination, along with its dosage, can be designed to suit an individual’s

genetic composition. This helps in trimming down the chances of an adverse drug reaction as well

as the cost incurred in unnecessary treatments. Such in-depth analysis of the genome has been

made possible through bioinformatics, using tools aiding in gene expression analysis, genome

sequencing and signalling pathway analysis, among others. Importance of pharmacogenomics

came to the fore when the government and private firms indicated growing interest in individualised

therapies to enhance a drug’s effectiveness.

The Indian government has been supporting the development of pharmacogenomics by funding

research initiatives such as the CSIR-led Indian Genome Variation database (IGVdb). IGVdb has

information related to 1,000 bio-medically and pharmaco-genetically appropriate genes across a

representative population covering a wide ranging genetic variety. Data includes information about

diseases ranging from clotting, altitude problem, retinitis pigmentosa, predisposition, malaria and

infections to asthma, diabetes, neuropsychiatric disorders, cancer and coronary artery disorders,

among others. Another CSIR-led initiative – Center for Drug and Research Institute (CDRI) – has also

been at the forefront in pharmacogenomics research, in the field of cancer biology. Recently, ICMR

formed a task force to promote research in this field.

A number of pharma companies – Avesthagen, TCG Life Sciences, Advinus Therapeutics and

Jubilant Biosys, to name a few – have started focussing on personalised medicine and are thoroughly

investing in this field. Pharmaceutical companies aim to eliminate the unpredictable nature of drug

development and bring new products to the market at a faster pace through personalised medicine.

Pharmacogenomics-enhanced drugs and diagnostics can lead to a revenue benefit of USD200–500

million for each drug gaining from premium pricing, as with its application, the success rate of a drug

can reach up to 100%55.

54 GVK BIO Newsletter, by GVK BIO, 201355 http://icmr.nic.in/bioethics/ELSI%20of%20Genomics.htm


43

Key initiatives by Indian companies in the field of personalized medicine

Jai Health The company launched Jai-Heart in 2012. It is the first genomic based risk

estimation solution for heart diseases developed specifically for the Indian,

Southeast Asian and Middle East population, based on a simple saliva test.

Avesthagen The company launched a five-year Avestagenome Project worth USD32

million in 2007. Avestagenome refers to the study of the Parsi population (a

genetically homogenous population of about 69,000 people) to determine

the genetic basis of longevity and age-related disorders inherent in the clan.

To capitalise on the growing prospects from the rising influx of lifestyle diseases in India, various

domestic companies are focusing on its research. For instance, Xcode Life Sciences, a start-up

based in Tamil Nadu, uses InDNA technology to provide personalised solutions for lifestyle-related

diseases, such as coronary, diabetes and obesity, using saliva samples. Also, Mumbai-based Acton

Biotech caters to cancer patients with a portfolio of genetic tests that support prediction of response

from chemotherapy drugs such as gefitinib and cetuximab. Likewise, Geneombio Technologies

offers predictive genetics and pharmacogenomics services, including gene-based prediction for

genetic susceptibility towards major lifestyle diseases such as osteoporosis, insulin resistance and

cardiovascular disorders.

Advent of an open source platform is another revolution in the bioinformatics arena. Availability of

open and free infrastructure for sharing bioinformatics research output has offered easy access to

developed algorithms, software and tools for researchers. Newer models with Open Source license

were developed for strengthening research in informatics-heavy areas.

Open Source Drug Discovery – Collaborate, Discover and Share

CSIR launched an ‘Open Source Drug Discovery’ (OSDD) project in 2008, under which an Indian consortium has been collaborating across the globe to provide affordable healthcare. OSDD, a web-based cyber infrastructure, facilitates input from researchers, IT professionals, teachers and students worldwide. The programme aims to provide high-quality research on therapeutics for infectious diseases (such as tuberculosis and leishmaniasis), which are widespread across developing countries, at a low cost. The consortium, which started with a seed fund of INR5 billion (USD85.6 million), has expanded to include more than 7,200 registered users from over 130 countries. The project demanded INR60 billion (USD1.0 billion) under the 12th Five-Year Plan.

Unlike the conventional set-up of a laboratory for drug discovery, OSDD showcases the joint researching abilities of thousands of young students and experienced researchers on one platform. This assists in mitigating the challenges faced during drug discovery and thus minimising the discovery time. Moreover, issues such as patents and confidentiality that add to the cost of discovery are eliminated as each researcher’s contribution is protected using the OSDD license. The cost can be reduced to less than USD100 million from over USD1 billion using the platform. Results of all projects and research activities are stored on an open-source platform (Sysborg 2.0) and researchers can avail funds by having their proposals reviewed by peers.

As India accounts for more than 30% of the global tuberculosis burden, this is the first target disease under the OSDD project. In line with this, in 2012, on World TB Day, OSDD, along with Global Alliance on TB (GATB) (New York), announced Phase IIb trial of the new TB molecule would commence in India. Clinical trials were expected to start by mid-2013 and a new drug targeting TB is likely to enter the market by 2019. This would facilitate treatment at affordable rates. CSIR aims to reduce deaths caused by TB from 1,000 a day to 100 by 2022. The OSDD paradigm in India has also been extended to include research on malaria and leishmaniasis.


44

Disease-specific databases to enable efficient tracking and treatment

Recognizing the importance of building national databases, the Indian government, along with

various public and private sector bodies, is increasing focus on gathering information related to

diseases prevalent in India. With the support of these databases, it aims to formulate effective

policies for ensuring the most suitable healthcare treatment. Furthermore, these databases support

the government’s aim to enhance focused research and innovation within the country.

Towards this end, ICMR launched National Centre for Disease Informatics and Research (NCDIR),

a centre primarily focused on building and maintaining national research database on cancer,

diabetes, CVD and stroke. The centre aims at leveraging the recent progress in the IT space in

its attempt to undertake aetiological, epidemiological, and clinical & control research across these

areas. NCDIR commenced work on the national registry for cancer in 1982 and the two-decade

long project has been a huge success. Today, India has significant valuable cancer data under one

roof. This database aids various healthcare professionals in their study regarding cancer incidence

and helps them devise treatment plans based on the analysed trends. Interestingly, data collected

under the programme has even helped in projections – cancer patients are expected to increase

17% to 1.15 million by 2020 from 979,786 in 2010. Some other notable trends that have been realised

from the registry data are: (i) the number of women cancer patients is 20% more than men; (ii) 20%

of the cases have their roots in tobacco-related causes; and (iii) breast cancer has been recognised

as one of the fastest growing cancers with total patients estimated to cross the 100,000-mark in

2020. Led by the success of the National Cancer Registry, the Indian government launched another

project covering stroke patients in 2013.

In 2012, MoHFW’s Revised National TB Control Programme (RNTCP), in association with National

Informatics Centre (NIC), developed a web-based digital database called “Nikshay” to enable better

compliance with the given tuberculosis treatment regimen (generally six months). Through this, the

government intends to establish real-time reporting of new patients and optimally manage already

existing cases. This would even help monitoring patients in remote locations, where the mobility

rate is high and people generally do not visit the same medical centre for follow-up treatments.

Currently, nearly 1.5 million tuberculosis patients have been registered on the database.

Commendable efforts among Indian institutes to track tuberculosis incidences and treatments

To further support the various initiatives undertaken by India to curb the incidence of tuberculosis, a national tuberculosis database has been developed through the combined efforts of various institutions. The first phase of this multi-centric project was designed by NJIL&OMID, Agra, and is currently being executed at NJIL&OMID Agra and MANIT, Bhopal. While MANIT created an online platform for storing biological data and developed warehousing and mining tools for the same, NTI, Bangalore, helped in resolving issues related to epidemiological and sociological fields as well as supervised the revised RNTCP programme.

The IOB, Bangalore, provided inputs through a TB-NET portal, a web-based portal for proteomic, host-pathogen interaction and building up pathway resources. Also, JNU, New Delhi, adds value through its Mycobacterial Genome Divergence Database (MGDD). The IISc, Bangalore, was responsible for the database development right from system level modelling and MTB’s genome profiling. Lastly, TRC Chennai undertook the task of annotating mycobacteriophages genomes under study and is currently building bioinformatics tools for analysing the database.’


45

Access to quality healthcare through telemedicine and m-health

The scalable and integrated IT potential showcased by India has assisted in delivering quality

healthcare in remote rural locations (refer Annexure 2). Telemedicine is one of the most prominent

developments in the health informatics field targeting the public heath segment. Along with the

central government, state governments have been equally active in fostering telemedicine. DeitY,

DIT, MoHFW and ISRO are the key bodies investing in this space. In addition, premier medical

college hospitals such as the All India Institute of Medical Sciences (AIIMS) Delhi, Postgraduate

Institute of Medical Education & Research (PGIMER) Chandigarh, Sanjay Gandhi Post Graduate

Institute of Medical Science (SGPGIMS) Lucknow, Pandit Bhagwat Dayal Sharma Post Graduate

Institute of Medical Sciences (PBDSPGIMS) and Christian Medical College have undertaken

several initiatives to foster the telemedicine network in India. Currently, the network has expanded

to more than 500 platforms across the country. These centres have been able to assist nearly

0.15 million patients56.

Figure 20 : Telemedicine


Andhra Pradesh

Arunachal Pradesh

Assam

Bihar

Chhattisgarh

Gujarat

Haryana

HP

Jammu and Kashmir

Jharkhand

Karnataka

Kerala

Madhya Pradesh

Maharashtra

Manipur

Meghalaya

Mizoram

Nagaland

Orissa

Punjab

Rajasthan

Sikkim

Tamil Nadu

Tripura

Uttar Pradesh

Uttarakhand

West Bengal

Andaman and Nicobar Islands

Lakshadweep

Delhi

Pondicherry

(2) (3)

(4)

(5)

(6)

(7)

(8)(9)

(12)

(13)

(16)

(27)

(29)

(30)

(1)

(1)

(1)(1)

(1)

(3)

(3)(3)

(4)

(44)

(2)(9)

(1)

(1)

(1)

(5)

(5)

Medical Institutes

Medical Colleges

Corporate Hospitals

The telemedicine platform has witnessed tremendous progress since 2000, when, for the first

56 Indian telemedicine market report by Frost & Sullivan


46

time, a telemedicine centre was set-up at Apollo Aragonda Hospital (Andhra Pradesh). In 2001,

ISRO commenced the telemedicine pilot project under its GRAMSAT rural satellite initiative. Initially,

the project was restricted to linking remote areas through Jammu & Kashmir, Ladakh, Andaman &

Lakshadweep islands as well as district healthcare centres in the North Eastern states. Currently,

ISRO’s network has expanded to every possible corner of the country, nearly linking 245 hospitals

across major cities. Moreover, ISRO established about 500 Village Resource Centres (VRCs) to

provide tele-education, telemedicine and online health-decision support services.

DIT leveraged on its medical and technological expertise to enhance the telemedicine framework

in India. So far, it has successfully developed 75+ nodes across the country:

• C-DAC linked the three premier institutes – AIIMS, SGPGIMS and PGIMER – under a project,

“Development of Telemedicine technology and its applications towards optimisation of medical

resources”. Also, with its Mercury software, it supported growth in telemedicine adoption.

• DIT built the Kerala Oncology Network focused on providing end-to-end treatment for cancer

by connecting hospitals in the Regional Cancer Centre , Trivandrum.

• The department prepared a project on the framework for IT infrastructure for health to resolve

information requirements among stakeholders.

• DIT worked on a report, “Recommended Guidelines & Standards for Practice of Telemedicine

in India”, in a bid to streamline telemedicine networks across India.

In 2005, a team was formed by MoHFW for efficient execution of telemedicine projects and

realize the full potential of the telemedicine platform. This taskforce comprises representatives

from various government ministries, technical bodies, such as ICMR, ISRO and MCI, as well as

medical universities and allied hospitals. Some successful projects executed by the MoHFW

are mentioned below.

• National Cancer Network (ONCONET) refers to broad-based diagnostic assessment and

consultation services for cancer with telemedicine nodes across the country.

• National Rural Telemedicine Network is an affordable rural telemedicine infrastructure and

knowledge network.

• National Medical College Network is a national grid that links few tertiary-care academic medical

institutions (identified as Medical Knowledge Resource Centres in a region) with all of the government

medical colleges in the same geography through a high-bandwidth optic fibre network.

Apart from individual efforts, several concerted efforts were undertaken to expand the

telemedicine network.

• Integrated Disease Surveillance Project (IDSP): It is a co-project by MoHFW and ISRO. It is

a decentralised state-based system for inspection of communicable and non-communicable

diseases for effective public actions to address health problems at the state and national level.

• Academic and private hospitals have committed large amounts of funds to expand

the reach of healthcare services via telemedicine. Some notable projects are

mentioned below.

• Apollo Telemedicine Networking Foundation (ATNF): It is a non-profit foundation of the

Apollo Hospitals Group. The organisation was much-admired for setting up the first ever

rural telemedicine centre in Andhra Pradesh, India, in 1999. Since then, the foundation has

expanded and is currently the nation’s biggest turnkey operator connecting 125+ peripheral

centres (including 10 overseas).


47

• Telemedicine and telepathology by Tata Memorial Hospital (TMH): TMH launched telepathology

at a rural cancer hospital at Barshi, Maharashtra, in 2002. Thereafter, the telemedicine network

was established connecting Dr. B. Borooah Cancer Institute, Guwahati and Dr. Walawalkar

Hospital, Chiplun, six hospitals in the Northeast region as well as regional cancer centres.

Currently, the network comprises 30 centres.

Given the continuous focus from both public and private sector players, the field of telemedicine is

expected to continue advancing at a robust pace.

M-Health – delivering healthcare by means of mobile communication devices – is another platform

attracting significant support from several governments focused on providing quality healthcare

in rural locations. Over the past few years, the field has expanded considerably, triggered by the

increasing number of mobile phone users (to 900 million) and a rise in value-added service offerings

by telecommunication service providers. The Indian government launched a mobile-based SMS

technology for its Mother & Child Tracking System (MCTS). This enables contact with nearly 25.2

million pregnant women and 18.3 million children that have been registered under MCTS. On similar

lines, mobile SMS is being used to reach out to the 3.2 million beneficiaries under the Central

Government Health Services (CGHS). ISRO also extended support to Shankar Nethralaya (Chennai)

and Meenakshi Eye Mission (Madurai) for launching mobile tele-ophthalmology services.

The initiatives have led to a rise in the adoption of m-Health; rural doctors now cater to twice the number of

patients’ vis-à-vis earlier. M-Health has the potential to cure around 1.1 billion TB cases in India by leveraging

Short Message Services (SMS) to ensure a patient’s compliance to the treatment. Remote diagnosis,

coupled with reduced hospital dependence (with the aid of m-Health), could likely lower hospital costs by

USD7.0 billion per year.

Nowadays, Geographical Information System (GIS) is being implemented across various villages in

a bid to associate health conditions of the rural population with their socio-economic environment.

This information is then used by policy makers at the central and state level for effective policy

making, considering the various spatial and temporal trends. Consequently, formulated policies

become more relevant for examining illnesses over a period of time. Several GIS projects targeting

the healthcare sector are currently in operation across India. Many states have incorporated GIS

into the healthcare model. For instance, Bhaskaracharya Institute for Space Applications and

Geoinformatics (BISAG), a Gujarat-based nodal body, assisted the MoHFW in launching GIS-based

applications in the health sector.

Efficient Management of Health Information

During the pre-independence era, the importance of information systems was recognised in the

Bhore committee report (1946). In 1983, the strategic significance was again highlighted in the

national health policy of India. In 1997, C-DAC, in partnership with SPGIMS, Lucknow, built the first

HIS software that was then implemented at SPGI and GTB Hospitals in New Delhi. Thereafter,

the National Rural Health Mission (NRHM), introduced as a flagship scheme of MoHFW, further

emphasised the need for an efficient HMIS. This was followed by the establishment of a national

HMIS portal by the Indian government in 2008 to store health information of both public and private

centres under one roof. Initially, the project was rolled out up to the district level; however, with

effect from 2011, it was extended to include data from Sub-District facilities. As of FY13, more than

650 districts are regularly accounting their performance on a monthly basis. Of these, 100% of the

districts in the HMIS Portal report on a monthly basis, while nearly 73% report data facility-wise.

However, the full potential of the system is yet to be achieved.

Over a period, through C-DAC, DeitY initiated a range of programmes in health informatics, including

E-Sushrut (Hospital Information Management System), Tejas (Hospital Suite for Oncology), Ayusoft

(Decision Support System for Ayurveda), E-Chavi (Picture Archival Communication System), Medical

Standards Libraries and iCare@Home (Integrative and Holistic HealthCare Solutions @home). Some

systems have been successfully incorporated in hospitals such as Guru Teg Bahadur Hospital


48

(Delhi) and Mahatma Gandhi Institute of Medical Sciences (Maharashtra). Many other hospitals are

interested in adopting such systems to simplify the administration process. Also, advisory bodies,

such as the National Knowledge Commission, plan to develop an open-domain EMR network to

aid better sharing of patient data and thereby improve public healthcare. Furthermore, the Indian

government has collaborated with IT companies (TCS and Wipro, among others) to develop

software and tools such as EMR and Decision Support System. Some examples of IT installation in

government hospitals are EMR solution by TCS in Tamil Nadu, Health NET in Goa Medical College

(GMC) Hospital, and HIS by Wipro across six hospitals in Delhi.

Figure 21 : Progress with the implementation of HMIS portal


Set up of national health

policy; HMIS developed by

collaborating with WHO and

NIC; HMIS implemented in

Gujarat, Haryana,

Maharashtra and Rajasthan;

field testing n one district of

Gujarat, Haryana,

Maharashtra and Rajasthan

Implementation efforts in 13

states and Union Territories in

phased manner; Revising to

HMIS 2.0; organized a work

shop with Government of India,

states, NIC, WHO, Planning

commission as Planning

commission as parties

MoHFW launched HMIS web

portal on 21st October, 2008.

It will act as a “Single

Window” for all public health

data. The horizon of the

portal is expanded to include

Sub-centre, PHC and Urban

Family Welfare Centres.

1990s 2000s1980s

Separately, state governments were actively participating in enhancing the application of IT in

healthcare. For instance, in Gujarat, HMIS was launched as early as in 2006 through joint efforts

by the government’s Health and Family Welfare Department (HFWD). The objective of the Gujarat

HMIS project was to improve healthcare monitoring and control system, thus ensuring better and

accurate treatment to patients. It aimed at eliminating paper work and automating the process

with routine reminders to patients undergoing treatments. As of June 2013, the project was able to

cover a total of 28.8 million patients under its unique Medical Record Document number. This was

ascribed to a strong network of 33 hospitals, a dental hospital, a mental hospital, over 2,500 nodes

and 12,500 trained users across the state.

In Maharashtra, the state government’s Medical Education and Drugs Department launched HMIS

in 2007. In around five years, more than five million patients have been allotted a unique health

identification number from four government hospitals situated in Pune, Mumbai, Aurangabad and

Nagpur. In addition to providing quick medical services supported by few prescription errors, HMIS

has cut down on patient waiting time with the availability of medical history online. This project won

the e-governance award from about 444 nominees in 2010. In addition, Delhi, Tamil Nadu, Kerala and

Karnataka have all implemented unique IT solutions to rationalise the process of hospital management.


49

Role of government in bio-IT – A global perspective

Government support has been critical for the development of the global bio-IT industry. Establishment of research institutions and organisations focused on the sector has been among the most crucial steps undertaken by global governments. These government bodies, in turn, provide huge funds and grants to public research institutes for conducting research. In addition, they assist private players operating in the sector. Apart from setting up focused organisations and launching various funding programmes, these entities also engage in human resource development with updated training programmes and courses. Moreover, researchers have access to open source databases and tools for their research processes.

Some key government-aided research organizations include National Institute of Health (NIH), National Centre for Biotechnology Information (NCBI) and its associates in the US, and the European Bioinformatics Institute (EBI) based in the UK. In Asia-Pacific, institutes such as DBT, India; Korean Bioinformation Centre (KOBIC), South Korea; NPO Bioinformatics and Japan Biological Informatics Consortium, Japan; CSIRO and Bioinformatics Resources Australia – EMBL, Australia; and Shanghai Centre for Bioinformation Technology, China are leading the development of bio-IT.


50

Early government initiatives and ongoing grants critical to US’ success in this field

The success of US, a world leader in the bio-IT space in terms of market size, has largely been

achieved through the government’s long-term vision of creating an environment conducive for industry

players. Efforts to ensure stringent intellectual property rights in framing regulatory policies and

funding biotech and pharmaceutical R&D activities have been pivotal in bolstering the bio-IT sector.

This, in turn, facilitated establishment of world-class infrastructure, a favourable business climate and

well-planned training & education in bioinformatics, system biology and healthcare. Furthermore, a

supportive regulatory environment attracted top bioinformatics and IT companies engaged in the

development of cutting-edge tools and services for the biotechnology and healthcare sectors.

NIH has been at the forefront of scientific innovations by funding programmes focused on

bioinformatics in the US. Towards this end, in 2000, the Biomedical Information Science and

Technology Initiative (BISTI) was launched to address biomedical computing issues in research

activities undertaken at NIH. Through BISTI, NIH aimed at garnering the full potential of biological

research, fostering collaborations and initiating trans-functional training. During the same year, the

National Programs of Excellence in Biomedical Computing (NPEBC) was launched under BISTI,

with an objective to provide cross-functional education to produce experts with multidisciplinary

skill sets. In addition, through BITSI, new business innovation funds were launched to promote new

companies and research centres for conducting R&D. Separately, NSF also launched an Integrative

Graduate Education and Research Traineeship (IGERT) programme to establish a cross-functional

workforce. Defence Advanced Research Projects Agency (DARPA) and Department of Energy

(DOE), non- biological institutions, placed emphasis on the importance of interdisciplinary training

in bio-IT. For instance, DOE was the first federal body to have invested in training and provide

funding for bioinformatics; the department has set up various institutes such as DOE Joint Genome

Institute and UCLA–DOE with programmes focused on DNA sequencing, proteomics, genomics

and computational biology, to name a few.

In terms of health informatics, the US government has played a major role by triggering

implementation of EMR, CDS and CPOE, among others, across hospitals in addition to storing

and managing national health records. Agency for Health Care Policy and Research (AHCPR)57 is

one of the 12 agencies under Health and Human Services (HHS), the US government’s principal

agency for health. The agency is responsible for introducing science-based solutions to enhance

decision making across levels right from patients, doctors, and healthcare organization leaders to

public and private policy makers. The programme is used to educate end users, i.e., hospitals and

doctors, with regard to the benefits, best practices and funding opportunities with the application of

IT in healthcare. Furthermore, AHCPR, in association with the National Library of Medicine (NLM), is

engaged in fostering the use of EMR in the country. Also, it actively participates in the development

of national data sets alongside research on vital data issues such as standards of health data and

confidentiality of personal health information in collaboration with HHS. In addition, the US FDA has

built a number of databases individually or in collaboration across diverse healthcare fields. For

example, it created a database encompassing information on paediatric medications catering to

parents and healthcare practitioners58. Also, in partnership with Agilent Technologies, the Centers

for Disease Control and Prevention and the University of California, the US FDA plans to build a

database of 100,000 food borne pathogens to identify quicker treatments over a period of five

years (beginning 2012)59.

57 also known as Agency for Healthcare Research and Quality (AHRQ)58 http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm305040.htm59 http://www.bloomberg.com/news/2012-07-12/u-s-to-map-100-000-bacteria-genomes-to-solve-food-

illness.html


51

Figure 22 : Progress with the implementation of HMIS portal


US

NIH

DARPA

DOE

NSF

AHCPR

FDA

Growth in bio-IT in EU primarily through collaboration

The bio-IT sector received noteworthy support from government institutions in the European

Union (EU). Germany-based European Molecular Biological Laboratory (EMBL) played a key role

in stepping up efforts of European companies and academia in bioinformatics by setting up the

European Bioinformatics Institute (EMBL-EBI). EBI, EMBL’s flagship initiative, supports bioinformatics

across Europe. The EMBL-EBI platform assists academia and industry players in research by offering

free data resources generated in earlier experiments. In addition, it undertakes basic research

in computational biology as well as offers a comprehensive training programme. Furthermore,

EMBL-EBI established European lifesciences Infrastructure for biological Information (ELIXIR)

as a special project. ELIXIR aims at building an organised network, which integrates results of

laboratories and databases across Europe. The network is based on the hub and nodes model.

As of now, 17 member states, along with EMBL, have signed a MoU to be a part of the network.

The UK government earmarked GBP75 million (USD117.2 million) through its Large Facilities Capital

Fund (LFCF), which falls under the ambit of the Department for Business, Innovation and Skills60, for

ELIXIR’s infrastructure.

UK’s position as the second largest player in the industry is supported by various councils and

agencies that provide funds for developing bioinformatics technologies. In early 2000s, to benefit

from opportunities arising in the post- genomic era, the Department of Trade and Industry (DTI)

initiated several schemes to encourage new participants in the sector. A scheme called Small Firms

Merit Award for Research and Technology (SMART) was launched to grant GBP2,500–450,000

(USD3,908.1–703,454.7) in funds to SMEs for supporting technological advancements61 . Also, DTI

collaborated with other councils such as the Medical Research Council (MRC) and Biotechnology

and Biological Sciences Research Council (BBSRC) to propel growth in the sector. For instance,

the department introduced a scheme, LINK, in collaboration with MRC and BBSRC. DTI aimed to

establish a platform facilitating public-private partnerships for smaller companies operating in the

sector. These schemes proved beneficial to both parties, with academicians obtaining access

to industry tools, facilities and expertise, while industry players gained access to scholastic

proficiencies, intellectual property and an expert workforce.

Under health informatics, member states in the EU showcased concerted commitment. The Union’s

60 http://www.ebi.edu.au/content/uk-invests-gbp-75-million-european-research-infrastructure-support-

knowledge-based-economy61 http://webarchive.nationalarchives.gov.uk/+/http://www.dti.gov.uk/bioguide/dti.htm


52

dedication is evident from the collaborative approach implemented by its member states in the

form of eHealth Action Plan to improve healthcare access and quality at the same time. The first

eHealth Action Plan was launched in 2004 and comprised everything from EMR and digital health

cards to adoption of a new IT platform for reducing errors and time. With the conclusion of the first

plan in 2010, the second eHealth Action Plan was introduced for 2012–202062.

To ensure cooperation among political bodies within EU states and eHealth stakeholders, the eHealth

Governance Initiative (eHGI) was launched in 2009. The initiative entails two projects: eHGov and

Supporting the European eHealth Governance Initiative and Action (SEHGovIA)63. While eHGov acts

as a stage facilitating technical and political teamwork among EU member states, SEHGovIA provides

information on the legal, ethical and regulatory framework. In addition, the European Institute for

Health Records, which was set up in 2002, played a vital role in encouraging the adoption of high

quality EHRs in the EU.

European Patients Smart Open Services is another scheme by the European government. Through

this, the EU aims at building a region-wide infrastructure for cross-border interoperability across

EHR systems. To further buoy the interoperability, in 2010, Healthcare Interoperability Testing and

Conformance Harmonization (HITCH) was launched in the EU to focus on testing and authentication.

In 2012, a group of 10 governments in the UK and other non-profit research foundations, led by the

MRC, planned the establishment of four Centres for electronic health data, called Health Informatics

Research Centres (HIRCs), with a funding of GBP17.5 million (USD27.4 million)64.

In addition to the collaborative efforts, various countries undertook key expansion initiatives in this

field. In 2013, MRC announced additional investments worth GBP20 million, doubling its original

aid, to establish Farr Institute65, a health-informatics research institute in the UK. The institute is

planned to have key centres in the cities of London, Dundee, Manchester and Swansea, and

would be connected to 19 UK universities. This initiative is expected to strengthen the already

established funding scenario in the UK. The step aims at not only supporting efficient health

administration of citizens but also showcasing UK’s EHR potential on the world map. Separately,

Sweden benefited from the government’s national policy of 2000, targeting health informatics;

in Germany, adoption of IT in healthcare was led by the government’s 2003 IT strategy called

Information Society Germany 2006. However, some initiatives had negative repercussions. For

instance, in 2002, the National Programme for IT (NPfIT) was launched in the UK to develop a fully

integrated electronic care records system; however, it was dismantled in 2011 due to failure. The

cost of the failed programme is estimated to be close to GBP7.3 billion (USD11.4 billion) vis-à-vis the

benefits of GBP3.7 billion (USD5.8 billion) as of March 2012 However, future repercussions have

not been considered in this figure. For instance, legal expense towards termination of Fujitsu’s

contract alone has been estimated at GBP31.5 million (USD49.2 million) over the past four years66.

APBioNet providing impetus to bio-IT in Asia-Pacific

While governments in the Asia-Pacific region have played a major role in the development of their

respective bio-IT sectors, Asia Pacific Bioinformatics Network (APBioNet) also deserves credit. Set

up in 1998, this non-profit global network is one of the oldest institutions for bio-IT in the region. The

consortium is engaged in enhancing network infrastructure, facilitating data exchange, developing

human resource by means of workshops and training & encouraging collaborative efforts. In

partnership with ASEAN’s Committee on Science and Technology (COST), APBioNet has also been

instrumental in formulating long-term road maps for ASEAN’s 10 member countries67. In addition,

62 http://ec.europa.eu/digital-agenda/en/innovative-healthcare-21st-century63 http://www.ehma.org/index.php?q=node/97464 http://www.mrc.ac.uk/Ourresearch/ResearchInitiatives/E-HealthInformaticsResearch/index.htm65 http://www.mrc.ac.uk/Newspublications/News/MRC00920766 The dismantled National Programme for IT in the NHS, House of Commons, 201367 Myanmar, Thailand, Singapore, Indonesia, Cambodia, Malaysia, Vietnam, Laos, Philippines and


53

the network has encouraged participation from non-member Asian countries, such as India, China,

Japan and Korea, through its ASEAN Dialogue Partner mechanism. Furthermore, it has supported

Pakistan and Saudi Arabia in project execution.

APBioNet has played an important role in collating views on policies, research, infrastructure and

education, thus propagating constructive activism across the sector. Additionally, in 2003, an

International Conference on Bioinformatics (InCoB) was launched as the official conference for

APBioNet. The annual conference provides a platform for scientists and researchers to share and

discuss ideas and insights on the growth of bioinformatics and technological shifts in the sector.

Eminent bioinformaticians from Australia, China, Hong Kong, India, Japan, Korea, Singapore, Taiwan

and Thailand, among others have been attending the conference.

In addition to the joint efforts, individual bodies such as KOBIC in Korea, National Institute of Genetics

(NIG) in Japan, and Shanghai Centre for Bioinformation Technology (SCBIT) in China have played a

major part in the sector’s overall development.

In Korea, several efforts have been undertaken to drive the sector’s growth. In 2012, the Ministry of

Health and Welfare launched a platform, “next-generation genomics agency for personalized medicine”,

by merging genomics-related groups. Furthermore, highlighting the importance of bioinformatics,

the government planned an USD1 billion, eight-year programme with major focus on genomics and

bioinformatics infrastructure with effect from 2013. With participation from five ministries, the programme

aims at improving coordination among research centres, thus evading overlapping investments. Also,

the Ministry of Education, Science and Technology aims to build a robust bioinformatics infrastructure

by enlarging the KOBIC. Moreover, to encourage private players, in particular, the government plans to

build another bioinformatics centre equipped with sequencing and super-computing facilities68.

Bioinformatics has been identified as a major funding priority by the Chinese government. Various

centres such as the Centre of Bioinformatics, Shanghai Institutes for Biological Sciences (SIBS),

Beijing Genomics Institute and SCBIT were established for supporting the sector’s growth. While

the Centre of Bioinformatics was established in 1996 as a Chinese node for EMBnet, SIBS was

built in 1999 to offer specialised databases and tools alongside training for interested scientists.

On the other hand, SCBIT, supported by the Shanghai government, focuses on data warehousing

and construction of specific databases. In addition, SCBIT enables data sharing produced during

experiments conducted in China and thus supports open source and grid-based e-Biologists’

workbench development.

With regard to health informatics, the scenario has been relatively poor in the Asia-Pacific region

vis-à-vis its western counterparts. Asia Pacific Association for Medical Informatics (APAMI) was

established in 1993 to promote health informatics. Under the aegis of APAMI, several conferences

across seven different Asian countries have been conducted over the last two decades with the

latest one held in China in 2012. In addition to encouraging bioinformatics in the region, APAMI

is responsible for the promotion of telemedicine and public health informatics. Yet, individual

governments in these countries have been comparatively late in launching action plans for

encouraging adoption of IT in healthcare. However, in the past few years, the importance of IT

adoption has increased with Asia expected to be among four of the top 10 fastest ageing countries

in the world by 2020.

South Korea has been comparatively ahead in the race. The country’s healthcare sector has been

increasingly incorporating IT to remain competitive and quickly advance to ubiquitous health

(u-Health), i.e., enabling constant examination of patient data even outside a hospital set-up.

The progress has largely been spearheaded by the Ministry of Health and Welfare (MoHW) and

Ministry of Knowledge Economy (MoKE). In 2004, MoHW laid the first pillar for standardising the

hospital information system by formulating a five-year plan under its Health Industry Policy Division.

Brunei Darussalam 68 Genomics and Bioinformatics in Korea, Korean Bioinformation Center, 2012


54

This, coupled with support from the Centre for Interoperable Electronic Health Records (CiEHR),

a research body, increased private players’ participation in the health informatics space. As per

MoKE, the initiative was successful with EMR being implemented in 66% of total hospitals, with

almost 100% adopting PACS by 2010.

Apart from South Korea, China, Japan and Singapore are some countries aiming to increase IT

adoption in the healthcare industry. In Singapore, the Ministry of Health (MOH) formulated a National

Electronic Health Record (NEHR) vision – One Singaporean, One Health Record – in 2009. The

USD144 million project aims to connecting all of the EMRs in Singapore. The first phase has been

successfully implemented and the second phase is scheduled for completion by 2015. Separately,

healthcare providers in the public sector – National Healthcare Group and Singapore Health

Services – are working towards increasing IT adoption to streamline processes across their group

hospitals. Similarly, China’s 3521 e-health project and Japan’s i–Japan strategy 2015 are some other

initiatives launched in the Asia-Pacific region.

Over the last decade, the government has played a key role in the development of the bio-IT sector.

By funding research initiatives across bioinformatics institutes, R&D laboratories, and autonomous

organisations, the government has been driving the sector’s growth.

For bioinformatics, DBT has been the apex body. Established in 1986, DBT (also the regulatory body

for biotechnology) aims to foster innovations and has the mandate to nurture adequately skilled

personnel in the bioinformatics industry. By providing the necessary infrastructure for bioinformatics

research and collaborating with foreign countries to promote exchange of such knowledge, it aims

to position India as a global leader in the bioinformatics space. Prior to DBT, the bioinformatics

industry was promoted by the National Biotechnology Board (launched in 1982).

MoHFW, CSIR, DIT, ISRO, DeitY and DST are some other prominent bodies that have funded various

projects for enabling bio-IT development in India. These entities initiated projects to effectively

utilise the country’s IT skills for the delivery of healthcare services. Also, CSIR, by offering funding

to research organisations (such as C–DAC), enabled the development of IT models, such as EMR,

telemedicine and CDSS, to ease the administration and workflow across hospitals.

Apart from the central government’s efforts, few state governments are promoting the bio-IT sector.

Andhra Pradesh and Karnataka have particularly made significant progress. A number of bio-IT

companies have set up offices in these two states due to the development of high-tech bio-IT parks.

The collaborative environment established with academia groups, industry players and research

organisations under one roof at these bio-IT parks has aided the Indian bioinformatics industry.

Similar initiatives have been undertaken by the state governments in Tamil Nadu, Orissa

and Gujarat, among others, to bolster the upcoming bio-IT sector. Moreover, these

governments are collaborating with research universities in their respective states

to fund various projects with or without aid from the central government. The sector

enjoys fiscal incentives in the form of subsidies on capital expenditure and tax holidays

for R&D spending.


55

Role of Government in Indian Bio–IT sector

Over the last decade, India’s government has played a key role in the development of the country’s bio–IT sector. By funding research initiatives across bioinformatics institutes, R&D laboratories, and autonomous organisations, Indian government has been driving the sector’s growth.

For bioinformatics, DBT has been the apex body. Established in 1986, the DBT (regulatory body for biotechnology which also takes care of bioinformatics) aims at fostering innovations and also has the mandate to develop adequately skilled personnel in the bioinformatics industry. By providing necessary infrastructure to conduct bioinformatics research and collaborating with foreign countries to promote exchange of bioinformatics knowledge it aims to position India as a global leader in Bioinformatics space. Prior to DBT, the bioinformatics industry was promoted by The National Biotechnology Board which was launched in 1982.

Some of the other prominent bodies that have funded various projects enabling bio–IT development in India are MoHFW, CSIR, DIT, ISRO, DeitY, and DST. These bodies have initiated projects that aim to utilize India’s IT skills in effective delivery of healthcare services. Also, CSIR, through its funding to research organizations like CDAC, has enabled the development of IT models like EMR, Telemedicine, CDSS and so on to ease the administration and workflow in the hospitals.

Apart from the central government’s efforts, a few state governments have also tried to foster the bio-IT sector in their region. Andhra Pradesh and Karnataka have particularly made progress. These two states are home to many bio–IT companies due to development of high–tech bio–IT parks by the state government. The concerted environment established with academia, industry and research under one roof in these bio–IT parks has helped the Indian bioinformatics industry.


56

Similar initiatives are taken by state governments of Tamil Nadu, Orissa, Gujarat, amongst many others to boost the upcoming bio–IT sector in India. Moreover, these state governments are collaborating with the research universities in the respective states to fund various projects with or without the aid of central government. Fiscal incentives in the form of subsidies on capital expenditure and tax holidays for R&D spending are enjoyed by the sector.

Establishment of BTISnet – one of the key breakthroughs

DBT is credited for the development of the Biotechnology Information System network (BTISnet) in

1987; currently, it is considered one of the key scientific systems across the globe. It is committed

to establishing a strong infrastructure and human resource network for bioinformatics. India was

the first country to build such a network. The consortium connects all of the institutions that are

classified under the ambit of DST, CSIR, ICMR and ICAR, in addition to various universities and

institutes categorised under the paradigm of the Human Resource Ministry.

BTISnet emerged as the largest network worldwide, expanding from nine institutions when initiated

to the current 168 research institutions across India and neighbouring countries. These institutions

are differentiated based on their levels in terms of Centres of Excellence (CoE), distributed

information centres (DIC), distributed information sub-centres (Sub DIC) and bioinformatics

infrastructure facilities (BIF). The network also includes a supercomputer bioinformatics facility and

an interactive graphics facility. Furthermore, the network stores over 100 specialised databases, of

which many have received global recognition.

BTISnet has enabled several R&D projects. With the BTISnet infrastructure, scientists have

published more than 1,000 bioinformatics research papers in journals in the last five years, apart

from 3,000 research papers in the field of biology/biotechnology69. Notable research areas include

gene analysis, protein structure prediction and synthesis, modelling, macromolecular assembly,

biology developing tools for peptide vaccines, metabolic pathways engineering and novel tools

for data mining.

Figure 23 : Number of bioinformatics specific publications by BTISnet

Source: DBT

96

147186

229

306 319

244

305336

424

525

0

100

200

300

400

500

600

2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Over the years, BTISnet has evolved to become one of the most important platforms for published

and unpublished databases based on primary and secondary data. A number of globally important

databases (EMBL, EBI, PDB, and GDB) have been mirrored on the network under the National Jai

Vigyan Science & Technology Mission, thus facilitating unhindered access to researchers. While

69 http://dbtindia.nic.in/uniquepage.asp?id_pk=63


57

PDB is mirrored at IISc, Bangalore, University of Pondicherry and University of Pune, GDB is hosted

only at IISc, Bangalore. Likewise, EBI has been mirrored at University of Pune and EMBNet at the

Centre for DNA Fingerprinting & Diagnostics, Hyderabad. Furthermore, BTISnet has set up a review

committee to streamline these databases and software packages against a benchmark.

The network supports building of a strong human infrastructure. In addition, teaching programmes,

such as MSc, MTech and PhD, focused on bioinformatics and computational biology, have been

supported by the network to develop skilled bioinformaticians. Also, various short duration

training programmes and workshops are conducted through the network, thus helping knowledge

development in the research society, including experimental biologists. BTISnet has also catered to

numerous bioinformatics companies directly or indirectly. Bioinformatics researchers across India

could play a role in government schemes, such as CSIR’s Biosuite of Tata Consultancy Services

(TCS) or Strand Genomics’ software packages, for visualization of data through this network. During

2012–13, more than 100 training sessions were conducted focusing on wide-ranging topics such as

NGS, drug discovery, protein folding and chemo-informatics, among others.

Figure 24 : BTIS network spread across India

Source: DBT

north eastern states to benefit from tailor-made projects

DBT set up a North Eastern Region-Biotechnology Programme Management Cell through Biotech

Consortium India Limited (BCIL) for encouraging biotechnology activities in the North East. Under

various DBT schemes, DISCs at BCIL are coordinating for the development of a comprehensive

dynamic website for online submission, review and monitoring of proposals submitted by project

investigators from the region. This was followed by the launch of NEBInet, a bioinformatics network,

to boost growth across eight states in the region. A total of 29 centres have been established,

of which one is a DIC (North East Hill University), two are DISCs (Institute of Bioresources and

Sustainable Development, and Sikkim State Council of Science and Technology) and the remaining

26 are BIFs (universities, colleges and institutions)70.

70 DBT Annual Report FY12


58

BPI – 2004 an effort towards making India globally competitive

India’s vast and diverse population faces the challenges of conserving biodiversity that ensures

food security, healthcare; dealing with bio-piracy; and protecting IPR of knowledge systems,

environment and education. Domestic issues are further elevated by globalisation, thus requiring a

modernised, globally competitive business environment. To cope with the rapid growth in science

& technology, policies encompassing essential industries (such as agriculture, manufacturing,

environment and services) need to be modified. Towards this end, with the prime objective of

ensuring India’s competitiveness on the global map, DBT formulated the Bioinformatics Policy of

India (BPI) in 2004. In addition to India’s global positioning, the policy aims to increase accessibility

to the post-genomic information data pool. The policy had aimed at building a USD10 billion worth

bioinformatics industry by the end of 10th Five–Year Plan71.

To achieve the goals mentioned above, DBT undertook the following strategies:

• Formulated a plan covering specialised areas in the sector that are essential for India’s

economic growth;

• Appointed an Apex Secretariat for efficient coordination in the system;

• Built computing and communication infrastructure for system design and implementation;

• Assisted and improved application of bioinformatics across various fields;

• Aided and endorsed organisations with comprehensive training and education programmes

on bioinformatics;

• Conducted tests at the national level for assuring quality human resource in the field of

bioinformatics;

• Ascertained connectivity with international resources for biotechnology information;

• Established an international institute to promote bioinformatics; and

• Encouraged international and entrepreneurial participation in the sector.

In addition, the policy includes future goals to generate globally accepted human resource strength;

undertake well defined R&D activities; encourage entrepreneurial spirit; globalise the national

bioinformatics initiatives; and reorganise BTISnet for improved results.

Figure 25 : Envisioned framework under the Bioinformatics Policy of India (2004)

Source: DBT

Policy Framework

Bioinformatics Policy of India -

2004

Establish an

international

institute

Human

resource

development

Promote R&D

and

entrepreneurship

Globalise

national

initiatives

International

recognition

Restructure

BTIS

network

71 Bioinformatics Policy Of India – 2004,DBT


59

Government’s bio-IT efforts visible in Five-Year Plans

Growing efforts by the central and state governments led to the sector’s inclusion in high priority

areas under India’s National Five-Year Plans. Furthermore, various initiatives directed at improving

the accessibility by establishing integrated national networks have been launched. This, in turn,

supported DBT’s efforts in publicizing bioinformatics tools and services among a large number of

scientists operating from universities and R&D institutions across India.

The Bio-IT sector is likely to be a beneficiary of the higher public spending on life sciences and

healthcare. The government’s funding for the lifesciences sector rose sixteen-fold to INR64 billion

(USD1.1 billion) during the 11th Five-Year Plan from INR4 billion (USD68.5 million) during the 8th Five-

Year Plan; the outlay for the science & technology sector was increased eight-fold during the same

period72. Similarly, 11th Five–Year Plan allocations in the healthcare sector were INR1.4 trillion (USD19.8

billion). Over a period, the sector’s strategic importance supported by the government, coupled with

additional funds from the private sector, has led to the setting up of a large number of biotech parks

and SEZs to encourage incubation of new companies and conduct extensive research.

Figure 26 : Five-Year Plans focused on the bioinformatics sector

Source: Five–Year Plans

7th Five-Year Plan

Established Biotechnology Information systems (BTIS) in 1986

10th Five-Year Plan

Planned to set National Bioinformatics institute under DBT on the lines of the National Center for Biotechnology Information under the National Institute of Health of the US

11th Five-Year Plan

Strengthening bioinformatics R&D Infrastructure by setting up more super computing facilities.

8th Five-Year Plan

Established BTISnet and connected DICs and SubDICs through satellites and terrestrial links

1985-90

1992-97

1998-2002

2002-07

2007-12

Mission to to establish India as

a leader in Bioinformatics

Focused on Investments on

agriculture biotechnology

Mission to expand

bioinformatics network

Focused on ramping up

capabilities and capacities

Emphasis on building high-

tech infrastructure

9th Five-Year Plan

Planned expansion of bioinformatics network and human resource development

In 1985, under the 7th Five-Year Plan, DBT launched Biotechnology Information Systems (BTIS).

During the 8th Five-Year Plan, a network programme (BTISnet) was established. All of the DICs and

SubDICs were linked with the help of satellites and terrestrial links to the network. An additional

number of centres were connected to the network that, in turn, supported in setting up the overall

infrastructure in terms of human resource, computing facilities, partnership and research sharing,

among others. The number of centres rose to around 70 by the end of the 9th Five-Year Plan73.

During the 10th Five-Year Plan (2002–07), DBT shortlisted bioinformatics as one of the high priority

sectors. The strategy highlights plans for human genome sequences, proteomics, structural biology

72 Five-Year Plans, Planning Commission73 http://www.btisnet.gov.in/contributors.asp


60

and bioinformatics in particular. During the same period, 30 new R&D projects and 200 software

packages were launched along with 26 copyrights focused on bioinformatics. Furthermore,

specialised higher level courses, such as MSc, MTech and PhD, were offered for bioinformatics.

Notably, 400+ short duration training courses were undertaken by over 4,000 researchers and

scientists. BTISnet further strengthened research work with more than 1,200 white papers published

during the period. Also, a dedicated high-speed network was established to improve BTISnet’s

accessibility to various databases. Connectivity at Sub-DICs was 512 Kbps, while that for DICs and

COEs was 2 Mbps. Furthermore, Biogrid India, a Virtual Private Network (VPN) with high-speed

connectivity, was set up among 12 major institutions across India during the same period74.

In the 11th Five-Year Plan (2007–12), the government aimed at re-engineering the bioinformatics

sector for conducting in-depth R&D and launching system biology. A total of 73 new bioinformatics

projects were funded. Access to high computing resources as well as programming knowledge

aided scientists in exploiting the true potential of bioinformatics for research, thus reducing the

researching cost. Separately, of the total 2,410 R&D projects implemented across various segments

under biotechnology, 12% focused on building international collaborations and human resource

in the field of bioinformatics during FY07–11. These projects evinced interest from more than

3,000 investigators and 6,000 research scientists75. Some ongoing projects include building of

the national databases on tuberculosis, drug target identification against Leishmania major and

Schistosoma mansoni, and drug optimisation studies for kinase inhibiters and signalling pathways.

Also, to strengthen the health informatics sector, the government allocated nearly USD50 million for

telemedicine during the 11th Five-Year Plan76. With the required infrastructure in place, the initiative

aimed at increasing the reach of healthcare through public-private partnerships.

Recommendations for the 12th Five-Year Plan

While the 11th Five-Year Plan mainly focused on building the computing capacity, human infrastructure,

and public health informatics, recommendations for the 12th Five-Year Plan include establishing a set-

up for integrating databases (building complex programmes), encouraging public-private collaboration

and incentivising the industry, in addition to the goals under the previous plan. A brief description of

these recommendations is given below.

Establish a national level bioinformatics institute: For efficiently storing the increasing amount of

data generated through high-speed sequencing technologies, there is a need to build a national-

level bioinformatics institute. With this, the highly dispersed and inconsistent databases produced

by Indian researchers can be grouped together. Also, validation issues can be resolved. It would

also aid in addressing the needs of Indian researchers majorly relying on international databases,

such as EMBL, which have reached their data storage limit. Towards this end, a National Data Policy

has been proposed to ensure all of the databases are registered, authenticated and stored in the

National Data Centre.

Augment computing capacities for driving research: Paucity of robust infrastructure that can handle

the huge deluge of data is the major challenge faced by biologists and researchers in the nascent

bioinformatics sector. The advent of new generation, high throughput technologies requires a

permanent servicing centre across existing facilities. This can be undertaken by the provision of

financial grants to these facilities. These servicing centres would act as wetlabs interconnected to

national institutions.

Encourage continuous innovation for developing novel software and tools by promoting

collaboration between DBT and DIT: The existing tools and software have already been utilized

by various parties in India’s bioinformatics sector. Currently, there is dearth of adequate research

for the development of new tools and addressing future challenges in the lifesciences domain.

74 Report of the Working Group for the 10th Five Year Plan (2002–2007)75 Report of the Working Group for the 11th Five Year Plan (2007–2012)76 Telehealth Report 2011, Telemedicine Society of India, 2011


61

Key institutes focused on pure bioinformatics lack the workforce that can programme codes for

addressing the rising complexity. To deal with these issues, collaborative efforts between DBT

and DIT needs to be encouraged. This would help in building the human infrastructure, exhibiting

both biotech and IT skills. The joint expertise can help in better understanding of the sector and

improved research across agriculture, healthcare, environment, and translational bioinformatics

used in the drug designing process and systems pharmacology.

Launch Glue Grant Research schemes: To boost interdisciplinary projects, glue grant schemes77

need to be announced. This would enable cross- sectoral research involving biologists having

expertise in the fields of medical and agriculture on one hand and biotech engineers on the other.

The scheme would also enhance the role of public-private partnerships in the industry. Furthermore,

DBT can initiate a dialogue with DSIR, thus demanding weighted tax deduction and other monetary

incentives for sanctioned institutions, organisations and laboratories.

Set up a fully operational HIS: The importance of a Health Information System (HIS) has been voiced by

various committees such as the Bhore Committee and Bajaj Committee in addition to the High-Level

Expert Group set up for health. A composite HIS, when fully operational, would store and manage data

related to birth and death. The integrated framework would provide information required for supervising

the disease burden across various communities that, in turn, would facilitate accurate decision making

and resource allocation. However, strong functioning of the HIS would need a policy for protection

of privacy rights.

Figure 27 : Benefits with the full adoption of HIS


Track birth and death

Servicing delivery data from HMIS

National Disease program monitoring

Nutrition surveillance

Emergency response support

Public health information

HR and financial management

Medical education and research

Regulatory report

Health information system

National Health

Information

Network

Connect district hospitals to leading institutions and improve healthcare: The Steering Committee

plans to ensure internet connectivity in every PHC and connect all of the district hospitals to superior

tertiary care centres through telemedicine. Other devices and platforms such as cell phones, Skype

and audio visual media are also likely to be used. While mobile phones would extend connectivity

of sub-centres based on the available infrastructure in each state, platforms such as Skype and

other audio visual media applications would help in capitalising the full potential of telemedicine.

Several other projects and collaborations initiated by government bodies

In addition to the allocation under the Five-Year Plans, funds were provided by various government

bodies, such as DeitY, ISRO, DIT, Ministry of External Affairs, and MoHFW, owing to the potential

and capabilities of health informatics in improving healthcare delivery. The initiatives comprise

the expenses for building a support system for information management and decision making as

well as offering medical libraries, PACS and allied digital technology that facilitate health delivery.

These government entities have also played an integral role in the implementation of public health

informatics and telemedicine.

77 Glue grant schemes: Linking basic and clinical science departments in inter-institutional linkages


62

The Indian government has made significant investments to fulfil the goals of establishing, enhancing

and efficiently sustaining the bio-IT industry. The government’s strategies have benefited bio-IT

activities undertaken by academic institutions and private players. Besides, these government

bodies have been collaborating to bridge the technological gap and boost overall growth in bio-IT.

Some key standalone and joint projects by several institutions are listed below.

• DeitY established the Bioinformatics Resources and Applications Facility (BRAF); BRAF’s Phase

II facilitates access to the Garuda grid infrastructure and grid-enabled resources (such as

computing power, databases and software) to the industry and academia groups.

• DeitY is playing a pivotal role in building the National Knowledge Database (NKD), which

aims to interconnect 1,500 institutions and research centres through a high-speed data

communication network.

• Through C-DAC, DeitY initiated a range of programmes in health informatics including

E-Sushrut (Hospital Information Management System), Tejas (Hospital Suite for Oncology),

Ayusoft (Decision Support System for Ayurveda), E-Chavi (Picture Archival Communication

System), Medical Standards Libraries and iCare@Home (Integrative and Holistic HealthCare

Solutions @home).

• CSIR initiated a novel ‘Open Source Drug Discovery’ (OSDD) programme to tackle

communicable diseases, especially tuberculosis and leishmaniasis, across developing

countries. Also, it initiated collaborative efforts to develop anti-malarial drugs and has received

remarkable interest from the European Union and Australia.

• ISRO, in partnership with the governments of Maharashtra, Chhattisgarh, Rajasthan, Orissa and

Karnataka, connected various speciality hospitals and medical college hospitals via satellite.

For example, initiatives by the Rajasthan government to build a telemedicine network between

six state medical colleges, 32 district hospitals and six mobile vans. In Punjab and Himachal

Pradesh, similar initiatives have been undertaken by the government.

• Apart from domestic projects, international alliances of these government bodies facilitate

dissemination of advanced, technology-based bioinformatics information to local players.

• For instance, DBT collaborated with Japan, Australia, Canada, China, Indonesia, the Philippines,

Thailand, Vietnam, Europe and the US to conduct various projects under genomics, proteomics

and drug discovery.

• DBT developed a mechanism aiding the exchange of information in bioinformatics within

SAARC member countries. It also collaborated with Israel-based Weizmann Institute of Science

(WIS) as part of an international cooperation programme in bioinformatics, with support from

UNESCO.

• The Indian government offers tax incentives for the development of the bio-IT sector. To

capitalise on the outsourcing capabilities achieved due to the country’s combined strength in

biotechnology and IT, the government built bio-IT parks that acted as a catalyst for the sector

in the same manner as Software Technology Parks (STPS) for IT.

Additional efforts required to address Ethical, Legal and Social Issues (ELSI)

The remarkable progress in the field of genomics, supported by conceptual and technological

advancements, is fraught with challenges. As genomics research requires collation of genome

samples and specific personal health information, assuring security for the basic rights of an

individual or group is a challenge. Thus, genome analysis can have extensive consequences related

to privacy, confidentiality, choice and the underlying probability for consequent discrimination


63

impacting the society and its future generations. Moreover, minor issues such as returning research

results to participants and agreement regarding the future use of those samples are impeding the

progress of researchers.

A few focused principles or recommendations are addressing these issues. The ICMR released a

‘Policy Statement on Ethical Considerations involved in Research on Human Subjects’ as early as in

1980. This was the first initiative where the Ethics Committee (EC) was set-up to ensure adherence

to official guidelines across colleges and research centres. This was followed by ICMR’s study

towards developing an ‘Ethical Guidelines for Biomedical Research on Human Subjects’ during

1997 which concluded in 200078.

One of the other major initiatives was the launch of the Universal Declaration on the Human Genome

and Human Rights in 1997, realizing that genomics research can invade the privacy of human society.

This was followed by the formation of a National Bioethics Committee under the aegis of DBT,

Government of India, in 1999. The committee was responsible for analysing the Universal Declaration

issued by the UNESCO, identify changes and formulate a policy to ease concerns existing in Indian

human genetic research and services. The committee identified some important pillars for a patient’s

safety, justice, privacy as well as research results by ascertaining integrity and respect among

researchers. A number of policies were documented for issues related to the human genome. These

policies were then synchronized with the Ethical Guidelines for Biomedical Research on Human

Subjects. Furthermore, with a changing research landscape and the advent of modern technologies,

these guidelines were revised in 2006.

WHO analysed the importance and underlying risks in conducting genomics research, predominantly

the multifaceted ethical and legal problems that can occur across diverse religious and cultural

communities worldwide. The organisation’s first initiative in the form of a comprehensive report,

“Genomics and World Health”, was released in 2002; it highlighted the need and laid the foundation

for structuring a new discipline – ELSI. In India, with the government’s support, ICMR planned a joint

WHO-ICMR Post Launch Interactive Session on ELSI of Genomics in 2002. Through its study on

“Ethical Guidelines for Biomedical Research on Human Subjects”, in 2006, ICMR stipulated broad

guidelines to address ethical issues faced by Indian researchers while performing genetic research.

Figure 28 : Basic principles outlined across various studies related to the role of ethics in genetic research

Source: BPI

Participating in genomics research to be at the sole discretion of the person or

group; involvement should be independent, conscious and driven by informed

permission; particpants with the criterion of diminished autonomy to be provided

safety

AUTONOMY

Information pertaining to any individual’s clinical trials or genetic tests classified

under private to be held as confidentialPRIVACY

Every individual to be treated equally and no bias among individuals or groups;

no damage to be caused and benefits to be incurredJUSTICE

Impartial access to information, tests and procedures to be granted to all of the

concerned individuals and groups EQUITY

78 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3267294/


64

Considering the moral, religious, and cultural backgrounds of the Indian populace,

the research undertaken on individuals needs to be explained in an easy and

comprehensible manner.

To achieve these principles, DBT stipulated few important criteria for researchers.

integrity, respect and Beneficence

The investigator should demonstrate sufficient level of integrity, professionalism and commitment

towards his/her research. From respecting welfare rights, customs and cultural beliefs to distribution

of research results, the participant’s safety should be prioritised over anticipated gains. Furthermore,

each participant should be thoroughly briefed with the associated risk and a corresponding

liability agreement should be signed between the scientist and the participating individual and/or

community prior to the commencement of research.

Justice

The research proposal should be designed with equitable benefits to all of the stakeholders. The

participating individual/community should be allowed to withdraw at any point and not be liable to

any unfair burden. The beneficiary should always opt for a fair selection as well as protect and share

the future benefits with participants.

consent

Before commencing any kind of research on any individual/group, consent needs to be obtained

from the participants. Individuals need to be completely updated about the processes, risk and

result outcomes. Thereafter, permission from the individual or from a person with lawful authority (if

he/she is incompetent/handicap/minor/challenged) needs to be obtained. The consent is valid only

for that particular research and if an individual’s data needs to be used for other research work, a

new permission needs to be obtained. All of this information should be drafted.

dissemination of research results

The research results should be published with scientific validation. The entire process, including

procurement of funds, should be made available to the public and thereby enhance their knowledge.

Results that indicate health implications on a participant should be shared with him/her only when

a suitable medical treatment exists.

iP rights and benefit sharing

IP rights on human genome may be granted or considered in agreement with national laws/global

treaties. A part of the profits earned by national/international entities, by means of human genetic

material, needs to be shared with the community. IPR rights need to be safeguarded and the

underlying gains arising from pharmacogenomics studies need to be shared.

Various policies governing gene therapy, testing, counselling and privacy, alongside rules for

human cloning as well as DNA and cell-line bank, have been formulated.

To fulfil the aforementioned policies, an Ethical Review Committee (ERC) was appointed by DBT.

The committee’s responsibility was to ensure adherence to all of the guidelines in the ethical

policies. Any research study undertaken in India needs approval from a national or an institutional

ERC. Furthermore, the policy framework of the funding/sponsoring country needs to be followed.

If any of the suitable clearances from all of the associated countries cannot be secured, then the

ERC’s functioning in those nations must be informed and appropriate waivers need to be obtained.

Moreover, if the research study is based on a new chemical/ biological entity, an additional

authorisation needs to be availed from the Drugs Controller General of India.


65

Moreover, with rising awareness, commercialisation of genome sequencing is expected to increase

and at-home genetic testing is likely to become more common. This would eventually lead to

growing interests among research participants to procure information on their results. International

organisations, such as WHO and UNESCO, have been constantly analysing the requirements and

formulating new guidelines relevant to researchers in developed and developing economies. With

this, the organisations aim to reduce inconsistency and ensure the adoption of a universal agreement

across the globe.

Recommendations and reforms required for regulations

With rapid developments in the field of genomics, unaccustomed ethical and legal concerns are

likely to surface. The progress witnessed in this domain should be gradually captured in policies

safeguarding and shielding the rights of individuals participating in biomedical research. Although,

India has laid down strong policy recommendations to handle ethical issues during the research

process, an absolute acceptance of some provisions has not been attained. Formulating detailed

comprehensive guidelines focused on a vast domain of research in a diversified country like India

is going to remain insufficient. This is primarily due to the fact that identified ethical guidelines are

just suggestions/advice and not a part of law. To resolve the concerns, effective adoption of these

guidelines should be mandated by including it in the law, as it is followed in the US and other

global economies. Having said that, in our opinion, considering all the possible uncertainties and

stipulating a long-term policy (targeting ELSI) is a very crucial step for the sector’s long-term growth.

Developing a long-term policy with set ethical standards

A long-term policy with benefits for all of the stakeholders will not only aid in protecting participants but

also play a key role in advancing research activities. Another spill-over effect would be increased public

awareness and rising confidence among private investors. Recommendations for addressing these

issues that can be used to guide research practices and stimulate policy development, are as follows:

establish a one-stop system for addressing elsi issues

There is a need to establish an autonomous, responsible and transparent regulatory framework to

ensure all of the ELSI issues faced during the research process are properly documented and an

appropriate policy is drafted. Currently, various SMEs operating in the sector are unaware about the

ELSI policy guidelines. DBT should impart the necessary knowledge regarding these issues within

various academic researcher’s community and public funded research centres. Also, a portal with

all of the relevant information needs to be set up for future reference by private players.

ercs to be built under proper surveillance

ERCs form an integral part in any research activity being undertaken in the country. Given the

complex nature of genomics research, there is a need to build ERCs demonstrating sufficient

expertise to foresee all of the ethical issues witnessed during the research process. Furthermore,

decisions undertaken by these committees should be independent of any political, institutional,

professional or market pressure. As there is no current law governing the registration, creation or

functioning of ERCs in India, the EC should devise its own separate standard operating action.

engage the public and develop a broad-based policy

The Indian government should ensure research continues to benefit the society, as a whole, while

simultaneously involving people throughout the research process. This would not only assist

in increasing the acceptance of genome research among the general population but also help

DBT in evaluating and building innovative schemes identifying research participants’ concerns

related to privacy, disposition and application of data at each stage. Rising acceptance of such

research proposals would simultaneously lead to easy availability of genomic research data for

scientific advancements.


66

Public and private players need to conduct surveys to analyse the issues and thereby schedule

training programmes for addressing them. These programmes can also help in familiarizing

participants about the implications of their genome samples in improving India’s healthcare. As

an add-on, India can even launch a multi-sectoral network combining views from representatives

across academic centres, private companies, public institutions and legal firms.

NHGRI’s ELSI Research Program

Recognizing the importance of data arising from mapping and sequencing in the HGP, NHGRI launched the ELSI Research Programme in 1990. It supports basic and applied research on the ELSI of genetic and genomic research for individuals, families and communities.

Through this programme, NHGRI primarily focuses on four key aspects: use & analysis of genetic sequences, clinical integration of genetic technologies, easing concerns over genetics research, and imparting public & professional information & training regarding these issues. Moreover, to continue being relevant in the rapidly growing genomic science research space, in 2011, NHRGI identified few other areas that need focus. The new strategic plan suggested it is imperative to constantly evaluate and modify the policies owing to the increasing level of complexity in genomics research. Also, permission needs to be obtained from concerned individuals to utilise the collated information on new healthcare and technology platforms such as EHRs, EMRs and personalized medicine. On a broader level, societal concerns underpinning beliefs encompassing latest genomic technologies and data need to be integrated into the society.

Notably, over 1990–2012, the programme invested nearly USD300 million, aiding close to 500 research and education projects, and conferences. With the support of these grants, 1,500+ peer-reviewed journal articles, books, newsletters, websites and television & radio programmes have been launched.


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Infrastructure Landscape

Favourable infrastructure landscape is a real impetus for the success of bio-IT sector in India. The key infrastructure parameters identified for this sector are – human resource, funding and connectivity. The study showcases the current status and challenges faced by India across these three parameters.

Human resource is considered very critical for bio-IT sector’s growth given the requisite of multidisciplinary skilled workforce having abilities to apply IT and software skills in resolving molecular biology concerns. Currently, the sector faces crisis of learned trainers leading to fewer expert bioinformaticians in the country. Funding, the other important factor essential for bio-IT’s success, has been gradually increasing with government playing the major role; however the figure is quite low in comparison to other developed economies like the US. The major hurdle is lack of sector focused funding combined with underdeveloped PE/VC market. The last key matrix connectivity is supported by few major networks in India. However, the bandwidth connectivity is very weak impacting efficiency of researchers operating in the field.

The section ends with recommendations across the three parameters based on global market study and practices adopted worldwide for the development of this sector. On the whole, these issues pertaining to bio-IT infrastructure landscape can be addressed by the unified actions of the government, industry players and academia groups.


68

Human Resource

Global picture

Educational infrastructure in the bio-IT space has undergone a considerable change over the years.

Establishment of dedicated institutions worldwide has played a major role in driving education and

research in this field. Due to bio-IT’s cross-functional nature, challenges were faced in designing

educational programmes with a multidisciplinary perspective. After nearly a decade of offering short-

term informal training courses, formal training programmes were seeded in 1998. It was then that for

the first time education was formalized and several requisite subjects ideal for bioinformatics were

identified. From unauthorised training workshops and courses to authorised certifications and from

diplomas to degree programs ranging from online self-educational distant learning all the way to

doctorates were introduced. Yet, due to the complex need for scheming a cross-functional course,

few universities offered diplomas and a degree in bioinformatics until 2001.

Over a period, various initiatives were implemented to develop the overall human resource skills

existing in the sector. Several programmes were undertaken to create awareness about the sector’s

widespread opportunity and the need for joint courses. While short-term courses majorly focused on

honing specific skill sets, long-term programmes encompassed overall bio-IT applications. Also, due

to the sector’s technological requirements, informal training in the form of on-the-job programmes

was given utmost importance and continues to remain the mainstay. Today, the bio-IT curriculum

has gradually evolved to incorporate inputs from diverse fields including mathematics, statistics,

chemistry, medicine and pharmacology. These courses can be segmented into three sub-groups:

fundamental bioinformatics (genomics, proteomics and computational biology), biology (biochemistry

and molecular & cell biology) and computer science (programming and database administration).

With constant efforts and initiatives, the awareness and scope of biotechnology and bioengineering

has been greater vis-à-vis earlier. The necessity to include bioinformatics as a subject in the

curriculum has been extensively acknowledged by researchers, academicians and industry players,

as well as government institutes. Interestingly, the advent of a genetic boom and computational

biology led the US and its allied counterparts, such as the UK, France and Germany, to include the

interdisciplinary branch of science – bio-IT – as a separate course. As early as in 1998, a report

presented to the Science and Technology department of the White House Office highlighted a

nationwide need for training and education in the bioinformatics domain. This was followed by the

initiatives of NIH and NSF in 2001, where the gaps encountered in bioinformatics training, education,

and career growth were identified and corresponding recommendations were undertaken. With

time, the courses transformed from mere minors to a complete PhD programme. Furthermore, the

Workshop on Education in Bioinformatics (WEB), a satellite meeting of the International Conference

on Intelligent Systems for Molecular Biology (ISMB), was launched in 2001. Through this, discussions

were held with regard to content, design and subjects within bioinformatics and the necessity for

incorporating bioinformatics concepts into the traditional biology course.

Compared to the US, educational infrastructure in the UK was relatively weak. However, the need

was identified quite early due to which an innovative educational platform – European Multimedia

Bioinformatics Educational Resource (EMBER) – was established by the European Commission

in 2001. EMBER is a platform with participation from 10 universities having expertise in different

fields. Through this platform, the European Commission aimed to locate training gaps, analyse and

modify teaching materials, collate text-based and web-based data under one platform as well as

streamline & standardise bioinformatics courses across Europe.

Separately, Germany witnessed increased activity in the early 2000s with most universities offering

bioinformatics courses. This was ascribed to the German Research Foundation (DFG) launching

a five-year funding scheme in 2000 to impart bioinformatics teaching at prominent universities

such as Bielefeld, Leipzig, Munich, Saarland and Tubingen. This was followed by the initiative to

establish six competence bioinformatics centres, with the German Federal Ministry of Education

and Research (BMBF) investing EUR50 million in 2001. Centres funded by DFG and BMBF are

responsible for establishing a strong bioinformatics educational platform in the country.


69

Figure 29 : Major non-profit organisations supporting global human capital development


PROMOTION

PACKAGING

PRODUCTS

PLACEMENT

Asia-Pacific

APBioNet

ME & Africa

ASBCB, ISBCB

Europe

EMBER, DFG,

MRC

US

NIH, NSF, ISMB

KEY BODIES

SUPPORTING

HUMAN

RESOURCE

DEVELOPMENT

GLOBALLY

Since the early 2000s, APBioNet, headquartered in Singapore, has been actively involved

in building a sustainable educational platform for bioinformatics. As part of its strategy, the

organisation partnered with various bodies in the west to foster growth in the Asia-Pacific region.

Some key representations include WEB (2001), the third East Asia Bioinformation Network meeting

in Singapore (2008), and the Bioinformatics, Biotechnology, Biocuration and Computational Biology

networks and societies meeting in Sweden (2012). These collaborations have helped APBioNet

in understanding the requisite skills required for bioinformatics education. It also encouraged the

adoption of domestic programmes and initiatives to enhance the educational landscape in the

Asia-Pacific region. For instance, APBioNet, in partnership with S* Life Science Informatics Alliance

and the ASEAN Virtual Institute of Science and Technology, offers online/distance bioinformatics

education and training. With these e-learning initiatives, a large number of scientists have been

able to share their research work and hold workshop conferences. Moreover, APBioNet developed

grid-enabled software and a distributable LiveOS with bioinformatics software to facilitate training.

LiveOS, built with support from National University of Singapore’s R&D centre, received financial

aid from Canada-based International Development and Research Centre. These initiatives, in turn,

led to the creation of trained bioinformaticians in the region. In addition, countries such as China,

South Korea and Japan have supported the development of skilled personnel in bioinformatics by

launching separate training programmes.

Though relatively underdeveloped vis-à-vis other geographies, the bioinformatics educational

infrastructure in the Middle East and Africa is improving at a slower pace. With the help of

organisations such as African Society for Bioinformatics and Computational Biology (ASBCB)

and Israeli Society for Bioinformatics and Computational Biology (ISBCB), training courses and

mentorship programmes have been designed for bioinformatics students in the region.

Current status and challenges faced by India in Human Resource

Since the early 1980s, human resource development started gaining traction in the bio-IT space

across India. Earlier, courses were designed to create awareness about the importance of


70

bioinformatics among biologists, scientists, statisticians, mathematicians and software programmers.

In the late 1980s, training programmes to build the requisite number of scientists, academicians

and industry experts were introduced. During the 1990s, due to the rising amount of complex

data generated with the help of high throughput techniques, the necessity to build specialised

technology tools for analysing this data became imperative. This, in turn, led to the development

of programmes focused on specific subjects addressing the new requirements in bioinformatics.

Some major milestones achieved during the period are depicted in the figure below.

Figure 30 : Timeline for introduction of key educational bioinformatics courses in India


An Advanced Diploma

course in bioinformatics

was started in five

DIC’s.

The course outline

was in tandem with

that proposed by

Russ Altmann in

1998.

Bioinformatics centre

(Pune University)

launched the first-ever

two years M.Sc. Course

in bioinformatics in

India.

The course was

funded by DBT’s

support.

M.Tech Program in

Computational and

Systems Biology was

launched for the first

time by JNU and

Pondicherry university

in 2006 and 2007,

respectively. M.Phil

programs were also

launched.

Promoting online /

distant education in

bioinformatics.

1990s 2000-05 2006-10 Way Forward

Currently, India is considered to have one of the largest talent pools worldwide. With a strong

and high quality educational infrastructure, including IITs, IISC and NITs, the country continues to

produce nearly 1.5 million engineers each year. This, coupled with the research talent passing out

from institutions such as IBB, IOB and BII, has aided building of a vibrant bioinformatics industry.

Moreover, BTISnet has played a major role in bridging the human resource infrastructure gaps.

In addition to the long-term specialised courses, such as MTech, MSc and PhDs, the network

conducts around 80–100 short-term training courses each year for enhancing the knowledge of

academicians and scientists linked to the network. Likewise, the five academic CoEs established by

the Indian government have expanded the educational infrastructure for bioinformatics.

To measure the knowledge and skills of students passing out from various institutions on a common

scale, several national level examinations such as Bioinformatics National Certification (BINC), CSIR-

UGC National Eligibility Test (NET), and Biotechnology Eligibility Test (BET) exist. While BINC, which

was launched by DBT in 2005, specifically focuses on bioinformatics, NET and BET are for testing

the generic knowledge possessed by bioinformatics students in lifesciences and the biotechnology

domains, respectively.

Despite the setting up of several bioinformatics institutions offering multiple training programmes

and courses, the gap between industry requirements and the underlying skill sets still exists. This

could be ascribed to the fact that majority of these training institutions have restricted capabilities

in terms of providing the right coaching or offer basic infrastructure. Though the gap is gradually

narrowing, India has not been able to fully capitalise on the bioinformatics advantage as researchers

and bioinformaticians have not mastered capabilities across biological and technological domains

– the most vital feature for the sector’s growth.

Currently, there are relatively fewer scientists having sufficient knowledge in the computer science

domain, thus posing difficulties for researchers in terms of completely exploiting the field’s potential

and broadening their scope. Also, bioinformatics courses offered alongside the ones opted for by

students have been largely dependent on an individual developer’s specialisation and preference.

However, there have been no efforts to understand the sector’s requirement.


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Expert’s view on the current scenario of human resource

“The biggest hurdle faced by India is the paucity of efficient teachers and researchers having adequate knowledge about both the streams i.e. biology and IT in the sector. This is due to the low quality and outdated nature of the current bioinformatics programs. There are several aspects in the current educational system that need modification, but unfortunately even the basic course outlines at many institutions are frozen in the era of 1980s and they are not in tune with the changes happening in this decade. This has limited the student’s exposure to updated and practical knowledge, thus affecting the long-term research conducted in the sector. Also, the system lacks a common evaluation matrix for the various programs, thus producing personnel showcasing different levels of capabilities”.

Dr. Ashok S. Kolaskar Ph.D.,D.Sc.(hc),F.N.A.,FNA.Sc.

Former Advisor, National Knowledge Commission, New Delhi Former Vice-Chancellor, University of Pune Professor, Biotechnology & Bioinformatics, University of Pune

Another challenge in the current system of bioinformatics education is quality and accessibility.

There is a dearth of quality teachers as they are not provided with the requisite guidance.

Consequently, there is a need to develop a strong framework so as to impart efficient training

to teachers and thereby students. Furthermore, on the accessibility front, few institutions

exist with quality training programmes across timeframes that cater to a wide array of student

requirements. As various governments, non-government and private institutes are engaged

in offering bioinformatics courses across different levels (ranging from graduation to post-

graduation), there is a significant variance in the quality of personnel passing out. Most institutes

are unable to train students on par with industry standards. Though various national eligibility

tests have been introduced by the government for certifying the quality of human capital output,

the purpose of streamlining quality across institutes has not been achieved. Notably, during the

BINC examination in 2013, just 38 of the total 676 candidates complied with the requirements

and received certifications.

Separately, flexibility in existing educational programmes is low, thus facilitating students’ progress in

only one aspect and restraining overall growth. The current teaching programmes provide theoretical

information to students, but hardly emphasize on nurturing them and extracting knowledge from

that information. Given the continuous developments in this field, there exists a significant need to

develop this expertise and accordingly incorporate amendments in the existing curricula. In addition,

the undergoing brain-drain scenario, supported by better growth prospects abroad, could aggravate

scarcity of learned experts in the long run. The rising need for skilled professionals across OECD

countries in the lifesciences domain in the near term may be one of the prime reasons for brain-

drain from India. This has been one of the key reasons delaying India’s aspiration to transform into a

cutting-edge innovation economy from a back-end research one. Notably, India loses around USD12

billion per annum due to this brain drain phenomenon79.

Recommendations and reforms to bridge the gap

Low level research undertaken in the bioinformatics sector could be ascribed to the underdeveloped

educational ecosystem laying lesser emphasis on manpower development. Challenges such as

lack of quality and accessibility of multi-disciplinary courses, combined with outdated programmes,

majorly impact the workforce quality. Moreover, lack of collaborative efforts in the form of virtual

classrooms and libraries as well as low interaction with industry participants has impeded the

sector’s success. Also, the brain-drain scenario is further aggravating the situation of already scarce

79 http://economydecoded.com/2013/09/brain-drain.html


72

teaching resources in the country. Existing issues in the educational landscape of the bioinformatics

sector can be addressed by the unified actions of the government, industry players and academia

groups. To bridge the gap between industry requirements and the educational infrastructure, the

following reforms could be implemented.

Formulating joint programmes covering iT and biology

India has already made its mark in the field of scientific research with a vast pool of technical

manpower. Several top universities offer quality education in the broad fields of biology,

biotechnology, biomedical and biochemistry, among others. However, with the changing scenario in

research, there is an emerging need to include specialised programmes. Thus, to ensure students’

learning and their all- round knowledge development, it is imperative to inculcate bioinformatics as

an obligatory subject across bachelors and master’s degrees pertaining to biotechnology.

In addition to incorporating bioinformatics as one of the subjects in the overall course curriculum,

there is significant demand for building human capital with in-depth expertise in bioinformatics,

in particular. Though some universities, such as University of Pune, Madurai Kamaraj University,

JNU, Bose Institute and IISc, were at the forefront in establishing and actively offering courses in

the bioinformatics domain, there is a need for additional institutes to fill the supply gap. Currently,

there is a shortage of workforce that possesses highly focused, research-oriented biological skills

alongside IT proficiency. Thus, it is necessary to devise courses that have a balanced mix of biology,

IT and statistics. While biology would enhance the understanding of genes, IT would impart the

requisite skills to build tools and software for storing biological data and statistics would support its

analysis. In line with this, various long- and short-term training programmes, along with master’s and

doctorates courses could be introduced across institutions.

Short-term training: There is a need to continue offering multiple short-term training programmes in the

form of workshops, seminars and conferences spanning an entire year. While additional focus should

be laid on building strong theoretical concepts, adequate hands-on experience also forms an integral

part of the training. Various training modules covering the entire spectrum of frontier bioinformatics

and computational biology need to be available, thus offering sufficient options to students.

Long-term training: Long-term training programmes should provide full domain knowledge to

bioinformatics students. Diploma and degree level courses in operation need to be modified to

incorporate practical aspects existent in the sector. Students trained in these formats should be able

to showcase the expertise essential to function in a practical set-up.

With the basic infrastructure of courses offered at various levels of diploma, degree, master and

doctorate in place, shortage of teachers with the requisite teaching skills and research experience

would gradually decline over a period. This, coupled with the necessity to invite faculty from other

local and international institutes, would decrease given the adequate availability of in-house

teachers at each institution. Moreover, with an increase in the numbers of courses offered across

the country, demand for experts and specialist teachers is estimated to rise that, in turn, can help

in attracting overseas bioinformaticians and aid in brain gain. Also, expansion and introduction of

novel research programmes in these institutes coupled with lucrative remuneration packages would

help in attracting the world-class talent back to the country. Several government departments and

councils have launched various fellowship schemes to attract scientists of Indian origin practising

across the globe. As part of these programmes, individuals receive a fellowship amount every month

as well as grants for pursuing scientific research in their particular field of expertise. Initiatives such as

the Ramanujan and Ramalingaswamy fellowships, Wellcome Trust and YIM have led to a brain gain

of more than 500 scientists. Some programmes and their governing bodies are illustrated below.


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Figure 31 : Initiatives undertaken to reverse the brain-drain in scientific research


Fellowship programs

DBT

Wellcome Trust

Ramalingaswamy

Re-entry Fellowship

Youth Investigator

Meet

DST

Ramanujan

Fellowship

Innovation in

Science Pursuit for

Inspired Research

CSIR

Outstanding

Scientists, STIO

Similar practises need to be promoted and certain initiatives specifically focused on the field of

bioinformatics should be launched. However, the level of funding and remuneration need to be

increased. For instance, Ramalingaswamy Re-entry Fellowship programme, launched in 2006,

currently provides a salary of INR75,000 (USD1,284) per month in addition to contingency grants

in the range of INR0.5–1 million (USD8,559.8–17,119.6) each year over a span of three years. With

regards to initiatives in other countries, the monetary benefits are relatively low.

China’s initiatives to control brain-drain hold lessons for India

The Chinese government has commenced various programmes to attract the nation’s best and brightest minds. Since the 1990s, the country launched major schemes to tackle the brain-drain issue.

During 1990–2010, the Ministry of Education provided nearly USD97.5 million as seed fund to 20,000 returnees to conduct scientific research in China. In 1994, Chinese Academy of Sciences (CAS), the state-run apex body, initiated a plan, wherein around USD325,000 per annum was offered to individuals returning to China. Notably, the programme has been able to attract around 1,568 scientists over a span of 10 years. In 2013, to further encourage more number of researchers of Chinese origin to return to the country, CAS assured these scientists would use 80% of their time for research and not for clerical and managerial activities. In 2010, the government launched another 10-year development scheme to attract nearly 2,000 top Chinese experts in the fields of IT, aerospace and biotechnology. Furthermore, the recently initiated 3H Project that covers housing, health insurance and home life (education for kids and employment for spouses) for the researcher and favourable policies offering 15% preferential tax to returnees starting high-technology firms have also encouraged experts to return. A similar initiative, “Talent Corp”, has been launched by the Malaysian government which offers a 15% flat tax rate for a period of five years to Malaysian professionals returning to the country.

To tackle the problem at the grassroots level, the Chinese government aims to attract younger Chinese students from overseas. Through programmes such as “root-seeking” summer camps, over 30,000 Chinese youths living in 55 countries are brought to the country each year with a view to make them more inclined towards their civilization and ethnicity. Like India, China’s technology ranking is also lower than its western counterparts and Japan. Also, dearth of funding remains a challenge for scientists who intend to turn entrepreneurs. However, India, which is facing similar issues, needs to learn from China and adopt related practices.


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need for improved level of actual and virtual collaboration across institutes

For universities that are multidisciplinary in nature and are simultaneously involved in offering a

requisite ecosystem to students, collaboration is a must. Collaboration and sharing not only enhances

the value but also the usefulness of individual resources. Promoting a knitted environment between

the academia and industry leads to building of a strong academia-industry bond, thus advancing

the success of bioinformatics. Collaboration can be either in real terms, by means of conferences,

workshops and seminars (where face-to-face participation is encouraged among individuals from

academia and industry players), or virtually by means of virtual classrooms and libraries.

Conversion of a knowledge resource into an economic success is reliant on the pace at which

new technology is being adopted by industry participants. Given the technology-intensive nature

of bioinformatics programmes, this push-pull strategy is the deciding factor for sustainability of

products. Applicability of this strategy requires constant and sustained liaison with industry players.

The human resource output would have a positive impact if corporate players start providing

inputs at the conception level and also offer ample exposure to potential talents through internship

programmes and placements.

IGNITE –Strategic alliances aiding human resource development

Biotechnology Industry Research Assistance Council (BIRAC) entered into a partnership with the Centre of Entrepreneurial Learning (CfEL), Judge Business School, University of Cambridge through which five BIRAC approved project proposals have been selected as part of IGNITE, CfEL’s flagship rigorous entrepreneurial boot-camp initiative. The programme focuses on training scientists and early start-up companies to enhance their entrepreneurial skills and capitalise on innovative ideas that have the calibre to be transformed into a business project. In 2013, five such candidates were selected and sent to Cambridge for a two-week training. DBT should consider launching similar programmes focused on bioinformatics.

In addition to the real interaction among academia groups, researchers and industry players, there

is a need for a robust network through which Indian institutes can share their research work and

tools as well as collaborate with international peers. Though India is one of the predecessors to

construct an infrastructure (BTISnet), additional emphasis needs to be laid on exploiting the sector’s

underlying potential. Under BTISnet, the launch of BIOGRID India by DBT has supported constant

exchange of database and software between the network’s individual centres/nodes; however,

there is a need to expand its reach and benefits to institutions across the nation. With the support

of this grid, universities and institutions would not only obtain access to resources that would aid in

synergizing their research but also support sharing of training materials and conducting lectures by

means of video conferencing virtual classrooms.

Collaborative endeavours, such as International Sequence Database Collaboration, need to

be undertaken among the NCBI, USA; EBI, UK and DDBJ, Japan. India can also emulate the

successful strategies of other global joint research groups such as the International Consortium

for Collaboration in Bioinformatics (ICCBnet), International Centre for Genetic Engineering &

Biotechnology (ICGEBnet) and APBioNet. Some initiatives that might lead to the establishment of

a closer link with international research institutes and thus foster better functioning of the existent

BTISnet in India are given below.

Access to mirror sites of renowned international servers for Indian institutes: Mirror sites provide

access to databases and tools available on international bioinformatics servers. Though various

Indian institutes/nodes in the network have access to mirror sites, including GDB, Protein Data Bank

(PDB), Plant Genome Data Banks, as well as databases of the European Bioinformatics Institute (EBI),

efforts should be directed to grant similar access to every Indian university, thus leading to better

exposure to the global network. Mirroring these websites would also ensure unrestricted mining

from superior quality databases.


75

Establishing virtual libraries and classrooms to promote virtual training: Storing the existing

compilation of databases and library resources in the digital form should be promoted as it enables

smooth sharing of resources and bibliographies across nodes/centres. Furthermore, virtual

classrooms (a simulation of real-world phenomena) can help in uniting academicians, students and

industry leaders from all relevant fields and regions.

To establish platforms similar to Bifx India Virtual Conference

With the success of virtual conferences held during 2007–09, Bioinformatics.Org announced the first-of-its-kind conference in India in 2010. The conference, “Bifx India Virtual Conference 2010 (Bifx10), was launched by Bioclues.org, in association with Bioinformatics Organization and APBioNet. The virtual conference boosted the level of virtual dialogues and collaborations between students, researchers and industry giants. Through this, Indian students received an opportunity to interact with top scientists worldwide in the fields of bioinformatics and computational biology.

After the success of Bifx10, in 2011, Bifx Africa-India Joint Virtual Conference 2011 (Bifx11) was jointly launched by Bioinformatics.Org, Bioclues.org and ASBCB.

Participate in international bioinformatics initiatives for joint training: Various nodes/centres of

BTISnet should be encouraged to participate in international initiatives so as to benefit from a

larger network. These initiatives hold utmost importance for India as it can play a pivotal role in the

ensuing bioinformatics revolution across the globe. India can modify its educational infrastructure

based on the changing environment worldwide.

GLOBULE – a joint initiative for online training

The S* Life Science Informatics Alliance (S*) was launched in 2001 by the Bioinformatics Centre of the National University of Singapore. Singapore University collaborated with Stanford University, Karolinska Institute and Uppsala University in Sweden, University of Sydney and the South African National Bioinformatics Institute at the University of Western Cape to design a global online course to tackle the shortage of trained bioinformaticians. S*’s major goal is to provide free introductory web-based education. Through the initiative, a global, bioinformatics unified learning environment (GLOBULE) was established with modular courses in the fields of genomics and bioinformatics.

The courses are offered to third-year undergraduates/graduates and students at the master’s level in bioinformatics, structural biology and medical informatics. Through GLOBULE, students would have the exclusive opportunity to work with teachers and other students across different time zones and continents.

Update and streamline bioinformatics activities by raising awareness

To ensure human resource development in India is of a global stature, several programmes aimed at

understanding the field’s scope and applications need to be launched at regular intervals. Awareness

about bioinformatics education is necessary to track changes in the fast growing discipline. Due

to the sector’s technology-driven nature, trainings undertaken by individuals are likely to become

outdated within a short timeframe. Thus, there is a significant need to conduct constant training for

students, teachers and researchers to ensure they remain up-to-date about emerging trends and

concepts. This can be undertaken by arranging programmes every summer and winter, conducting

refresher courses and facilitating training at world-class international universities. Furthermore,

people can be updated about technological advancements by conducting web-based learning

over the BTIS portal, providing news updates, building content by means of multimedia & e-learning

packages and maintaining a handbook on experts in bioinformatics. Additionally, another challenge

in terms of understanding the actual demand-supply gap can be eliminated by conducting surveys,

which would include opinions of academia, industries and individuals planning the curriculum.

Based on the survey results, the changes can be incorporated in the course outline.


76

To increase the importance, relevance and adoption of national eligibility tests, the certification

should be made mandatory upon completion of courses across institutes. With this, institutes would

ensure quality education in bioinformatics as a fewer number of certified students would stand as

a testimony of the teaching capabilities. Also, the credibility of these certifications is expected to

increase with industry players offering placements to certified students. Moreover, incentives and

cash prizes offered to top students need to be raised.

Funding

Global picture

In the early 90s, funding primarily originated from government bodies due to the capital-intensive

nature of the bio-IT sector. Though the sector was relatively underdeveloped during the period,

government entities recognised the growth prospects and launched various grants and schemes.

Notably, the collective expenditure on bio-IT research has been significant with NIH – the leading

contributor to biomedical research worldwide – alone spending close to USD32 billion on genetics

research over FY09–12, with another USD16 billion estimated to be invested over FY13–1480. The

US is likely to garner a major share in global spending. This could be ascribed to the various funding

programmes of government institutions such as NIH, NSF, and DOE.

Figure 32 : Genetic–related funding by NIH in the range of USD7.8–8.2 bn per year

Source: NIH; e:estimate

7.8 8.0 7.8 8.2 8.2 8.2

FY09 FY10 FY11 FY12 FY13e FY14e

Gene therapy Gene therapy clinical trials Genetic testing Genetics

The funds support research carried out at NIH’s National Human Genome Research Institute

(NHGRI) and National Institute of General Medical Sciences (NIGMS). A separate department

devoted to bioinformatics has been established under NIGMS. The department includes biomedical

technology, bioinformatics, and computational biology. Some key research programmes by various

institutes under the NIH are mentioned below.

NHGRI

CSER programme: The Clinical Sequencing Exploratory Research (CSER) programme was launched

in 2010 to develop methodologies to incorporate sequencing into the clinic and conduct ELSI

research to correctly apply personal genomics data for medical care. The programme was extended

for another funding cycle in 2013. So far, it has supported nine multi-disciplinary projects, nine ELSI-

specific projects, and a coordinating centre that pools researchers from varied fields and assists

them with funds to analyze issues related to the application of genomic sequence data in the clinic.

80 NIH outlay statistics report


77

NLM

NLM express research grants in biomedical informatics: Grants under this programme are offered

for conducting innovative research in biomedical informatics. The funding limit is pegged at

USD250,000 each year in direct costs. Furthermore, the scale of the project proposal shall

determine the duration with a maximum period being four years.

NSF

IGERT: Launched in 1997, Integrative Graduate Education and Research Traineeship (IGERT) is

focused on bridging the funding challenge faced by PhD scientists, engineers and educators in the

US with interdisciplinary backgrounds such as bioinformatics. Since inception, the programme has

provided funds to nearly 6,500 graduates and granted 278 awards81.

To ensure improved healthcare, the US government implemented the Health Information Technology

for Economic and Clinical Health (HITECH) Act. The case below testifies the rising importance of

EHR in the US.

US government’s EHR efforts reap benefits

The US Federal government implemented the HITECH Act under the American Recovery and Reinvestment Act of 2009 (ARRA) with an aim to encourage all doctors and hospitals to adopt EHR for improved healthcare solutions. Nearly USD19.2 billion was earmarked for EHR adoption. However, Congressional Budget Office estimates the spending to be as high as USD36 billion, as per a report, “Health IT and Rapid Adoption of Electronic Health Records in the U.S., Impacts and Opportunities for Medical Devices”, by PDR Network in 2011.

The results have been encouraging; the number of hospitals having basic EMR increased from 9% of the total in 2008 to 44% by 2012. This was ascribed to various incentives, in the form of payments, assured to participating hospitals. Notably, 79% of all eligible hospitals and 56% of ambulatory providers received an incentive payment as of March 2013. With this initiative, hospitals have incorporated EHR as part of their routine. For instance, while the policy required hospitals to use CPOE for minimum 30% of their patients, hospitals have reported using CPOE on an average for 84% of patients.

To lower healthcare cost, cut medical errors, and improve care, we’ll computerize the nation’s health record in five years, saving billions of dollars in health care costs and countless lives.”

– President Barack Obama in First Weekly Address, 24 January 2009

Apart from funding research initiatives in the US, NIH is committed to help foreign organisations

through overseas grants. One such recent example would be the Human Heredity and Health in

Africa (H3Africa) programme. NIH, in partnership with the Wellcome Trust and the African Society of

Human Genetics (AfSHG), is funding widespread research undertaken by African researchers on

the local population. H3Africa entails studying the impact of genes and environment on diabetes,

heart diseases, obesity, tuberculosis, and sleeping sickness. At the end of 2013, NIH awarded an

additional USD17 million to fund 10 new genomics projects over a span of four years following the

initial commitment of USD25 million in 2012. To date, the total amount of funding granted under

the H3Africa programme aggregated USD74 million82 as of 2013. This fund strengthens the US’

commitment to support genomics research activities in Africa.

81 http://www.igert.org/public/about82 http://www.nih.gov/news/health/oct2013/nhgri-18.htm


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The UK government is inclined towards driving bioinformatics research. Under its Department

for Business Innovation and Skills (BIS) programme, through the Large Facilities Capital Fund,

the government earmarked GBP75 million (USD117.2 million) for building the ELIXIR research

infrastructure in Hinxton, Cambridge. Other prominent bodies funding the development of bio-IT in

Europe are mentioned below.

• Biotechnology and Biological Sciences Research Council (BBSRC) and Economic and Social

Research Council have undertaken several funding initiatives focused on academic and trans-

disciplinary research, respectively.

• Germany-based EMBL is a key body aiding European efforts in the field of bioinformatics.

Unlike the US, where the public and private sectors offer financing for the bioinformatics

industry, VCs are the most important source of funds for European bioinformatics companies.

Emerging nations are increasing funding for bio-IT. In China, government institutions such as the

Centre of Bioinformatics, Shanghai Institutes for Biological Sciences (SIBS), Beijing Genomics

Institute and SCBIT are continuously supporting the sector’s growth. Also, the Korean government

launched a USD1 billion, eight-year programme with major focus on genomics and bioinformatics

infrastructure in 2013.

Several government bodies have partnered to foster collaborative research activities within their

communities. For instance, Singapore’s Agency for Science, Technology and Research, Biomedical

Research Council (A*STAR) and Australia’s National Health and Medical Research Council, (NHMRC)

entered into a joint agreement to conduct research in the field of integrative technologies, which

includes bioinformatics, genomics and proteomics, in 2011. The total fund allocated towards this

cooperative research programme was AUD3.5 million. A total of six research proposals were

funded with each project receiving grants of AUD390,000–780,00083.

Though initially bioinformatics research was primarily driven by funds from the government and non-

profit institutions, private players have also entered the field, as evident from the rising level of PE/VC

participation. Given the unavailability of statistics for bioinformatics, in particular, we have considered

the broader section, i.e., biotechnology. The sector managed to raise a total of USD4.5 billion through

470 deals in 2013. In value terms, the deals rose 8%, but declined 2% in terms of volume84.

Current status and challenges faced by India in funding

Government and non-government participants have increased capital outflows to boost R&D and

build the requisite infrastructure for bio-IT. India has six major government agencies – DBT, DST,

CSIR, ICMR, DeiTY and DIT – that are responsible for funding and supporting bio-IT research. In

addition to the government’s efforts, various non-profit agencies have increased investments in

lifescience projects. Over a period, the funding scenario has drastically transformed from DST’s

Technology Development Board (TDB) and CSIR’s New Millennium Indian Technology Leadership

Initiative (NMITLI) to new sources such as Small Business Innovation Research Initiative (SBIRI),

BIPP and BIG alongside the evolving PE/VC market. However, there is little change in terms of

investments in lifescience companies.

Bio-IT to benefit from higher budgetary allocation for lifesciences and healthcare

The field of Bio-IT is set to capitalize on the expanding budgetary allocations for development

in the lifesciences and healthcare domains. While bioinformatics would gain from allocations to

the Ministry of Science and Technology, which includes DBT, DST and DSIR, health informatics is

expected to benefit from the spillover effect of an increase in allocations to the MoHFW, DeiTY and

83 http://www.nuhs.edu.sg/research/funding/all-research-funding-opportunities/astar-australian-

national-health-and-medical-research-council-nhmrc-joint-grant-call.html84 http://www.pehub.com/2014/02/vc-funding-in-life-sciences-declines-in-2013-report/


79

DIT, given the growing significance of IT adoption. Apart from DIT, ISRO and renowned medical

institutions, such as SGPGI, AIIMS, PGIMER, AIMS, SRMC, as well as private players – Asia Heart

Foundation, Apollo Hospitals, SGRH, Fortis and Max – have undertaken noteworthy initiatives for

bolstering the health informatics market in India.

Allocation to DBT nearly double

Government funding to the lifesciences sector has accelerated due to the large-scale progress in

the field of biology coupled with new technological advancements that generate significant amount

of high quality data. Under biotechnology, there has been a significant increase in outlays over

the past few decades. Since its establishment in 1986, DBT’s budgetary allocation has increased

manifold from INR404 million (USD6.9 million) in FY88 to INR1.13 billion (USD19.3 million) in FY98

and INR14.9 billion (USD255.1 million) in FY1385, indicating the importance of the sector’s R&D and

infrastructure development. Bio-IT, recognized as a frontline applied science and a facilitator for the

study of biological data deluge, would benefit from this expansionary budget.

Figure 33 : Allocation of budget (INR billion) to DBT during the Five-Year Plans

Source: Planning Commission Five-Year Plans

7th Five Year Plan

8th Five Year Plan

9th Five Year Plan

10th Five Year Plan

11th Five Year Plan

12th Five Year Plan

Science & Technology Biotechnology

Funding by other government agencies

Besides DBT, other government agencies have been at the forefront to support research and

young entrepreneurs in the bio-IT sector. The Department of Health Research (DHR) and ICMR

which provides grant-in-aid to scientists and researchers for projects based on affordable

technologies, reagents and methods for public utility, have earmarked INR100 billion (USD1.7 billion)

in the 12th Five-Year Plan. Through this, the department also aims to establish multidisciplinary

research centres across 150 government medical colleges. Additionally, DBT’s funding to CSIR led

to the development of various software, databases, mirror sites and web services in varied fields

including bioinformatics. One such example would be the development of IGVdb in the field of

pharmacogenomics. Separately, to boost R&D in drug discovery and infrastructure projects, the

Indian government set up a USD2.2 billion venture fund. This scheme has been able to promote

innovative research in the biotech sector as a whole.

DBT has been actively supporting high–risk research projects and encouraging start-ups by offering

financial assistance to conduct R&D across all phases of product development. Given the lack of

seed funding available in the biotechnology sector, the department launched the Biotechnology

Ignition Grant (BIG) scheme in 2012 to foster nurturing of novel ideas. The scheme offers initial

funding and mentorship for conceptualizing ideas to budding entrepreneurs from academics, start-

ups or an incubatee. BIG Innovators are mentored by three BIG Partners: C-CAMP (Bangalore), IKP

Knowledge Park (Hyderabad) and FITT, IIT (Delhi). The programme is aimed at supporting high level

of innovation only up to the proof-of-concept stage. So far 30 entrepreneurs have been provided

initial seed funding of INR5 million (USD85,598) each.

85 Annual Budget 2013, DBT India, 2013


80

Figure 34 : Funding lifecycle


BIG: Idea Funding

SBIRI: Early stage Funding

BIPP: Process development, validations and trials

BIRAC: Commercialization Funding

SBIRI, a funding programme launched by DBT in 2005, nurtures the second phase of product

development. The initiative is one of its kind, early stage innovations based on the PPP model. The

programme, with grants ranging up to INR5 million (USD85,598), reduces the financial constraints

impeding SMEs in conducting successful R&D in the biotech sector. It also offers interest-free

loans during the early phase of product development, thereby ensuring timely access to adequate

funds. Through this initiative, the department aims to encourage and facilitate private players to

willingly espouse the innovation corridor through new ideas and additional risks. One of the other

advantages of SBIRI is the interaction between academia groups and industry players that fast-

track product and process development. Nearly 100 public-private joint projects have been set

up so far. Moreover, SBIRI has won 6 patents and developed 16 technologies across agriculture,

healthcare and instrumentation sectors. A total of 134 projects have been supported with cumulative

investments of USD78 million. Due to the need for affordable health among India’s vast population,

most funds have been directed to the healthcare sector. On the basis of sector-wise distribution

of funds, healthcare accounts for the largest share (60%) of total projects (134). Some successes

include the three novel drugs currently in Phase II and Phase III trials and three vaccines, of which

two have been launched in the market.

Figure 35 : Major portion of funding to healthcare

Source: BIRAC Annual Report 2012–13

60%70%

17%18%5%1%18% 11%

0%

20%

40%

60%

80%

100%

120%

SBIRI BIPP

Healthcare Industrial biotechnology Secondary agriculture Agriculture

Launched in 2008, Biotechnology Industry Partnership Programme (BIPP), an industry collaboration

scheme, is a cost-sharing model to undertake high-risk innovation research in futuristic technologies


81

with huge economic prospects. The programme facilitates collaboration between industry players

and academia groups and aims to retain ownership by IP creation. The scheme is focused on

evaluating and validating the healthcare product through clinical trials (Phase I, II and III). As of date, 51

companies have been the beneficiaries with around 60 projects supported under the scheme. Also,

under BIPP, the healthcare sector commanded a major portion of funds (70%). To expand the ambit of

programmes such as SBIRI and BIPP, DBT aims to launch new schemes such as Bridge Funding. The

funding would assist companies in terms of raising private equity or launching their IPOs.

Incorporated by DBT in 2012, Biotechnology Industry Research Assistance Council (BIRAC) functions

as DBT’s interface window to encourage emerging companies in the biotech sector. The platform

has been designed to ensure a favourable ecosystem that promotes innovation and provides

financial and technological assistance to SMEs and start-ups. The BIG scheme is one of BIRAC’s

initiatives to foster early-stage innovation by funding and mentoring prospective ideas. Furthermore,

the Council is responsible for conducting IP due diligence for all of the qualified proposals under

DBT’s various funding schemes such as BIPP and CRS. Additionally, the government plans to launch

a Technology Acquisition Fund under BIRAC to purchase latest technologies existing in the global

or national R&D space.

To smoothen the process of academic research through product development and commercialization

stages, a new programme – Contract Research and Services Scheme (CRS) – was launched in early

2013 by DBT. With this, BIRAC aims to extend its commitment to academia groups by allocating an

industry partner in the contract research mode for undertaking their research leads through the

validation and translation stages. The funding set-up operates as a grant awarded to both industry

players and the academia partner. While the engagement of the industry participant remains limited to

that of a validation partner on a contractual basis, the IP rights are enjoyed exclusively by the academic

participant. On the whole, the scheme assists academia groups in validating a particular process or a

trial product by employing a contract research and manufacturing (CRAMS) industry player. As of date,

of the 84 proposals, 7 have been shortlisted that include 9 academic and 7 industry partners.

Though underdeveloped, health informatics has been gaining significant traction with rising

interest and investments from both government and non-government stakeholders. Interestingly,

DIT played a pivotal role in the country’s telemedicine network by providing funds at every level

– from the launch of a pilot scheme to a full-fledged network implementation. DIT also funded the

software development activities undertaken by C-DAC which led to the building of Mercury and

Sanjeevani software. In addition, it funded the telemedicine project that involved three reputed

institutions: SGPGI-Lucknow, AIIMS-New Delhi and PGIMER-Chandigarh. Moreover, DIT funded the

establishment of ONCONET, a network offering telemedicine solutions for cancer discovery, cure,

pain relief and patient’s treatment and continuity of care.

Though non-government funding, in the form of PE/VCs and angel investors, has been in the

nascent stage, few companies have capitalised on the same. With Indian VCs and angel investors

unwilling to offer funding due to lack of sector awareness, companies are targeting angel investors

worldwide. For instance, InterpretOmics, a bioinformatics-based big data start-up, successfully

raised USD1.6 million in angel funding from a Singapore-based investor. The company aims to

utilise the funds for expanding its cloud-based software business focused on genomics. Apart from

the PE/VC source, networking conferences have proved fruitful for SMEs in terms of procuring

funds for their long-term development goals. These conferences enabled bio-IT companies to not

only interact with giant pharmaceutical firms, VCs and bankers but also facilitated interaction with

foreign investors. For example, Lifespring Ventures, led by Nadathur Holdings and Investments,

funded few start-ups in the lifescience domain.

BioInvest – an interactive platform by ABLE

ABLE, the exclusive forum representing India’s biotechnology sector, launched a flagship networking conference BioInvest in 2006. Through this, the forum aims to bring biotech companies, institutional investors and investment bankers on a common platform in a bid to exploit opportunities for investments and collaborations for stakeholders. Over


82

the years, the platform has been able to aid discussions among the investor community and veteran bio-IT players.

Though the Indian bio-IT sector receives adequate financing from the government, its prospects

are huge; thus, the role of PE/VC funds is considered crucial. However, over the years, the sector

has not been able to attract sufficient PE and angel investors due to the underlying uncertain

long-term regulatory policies, high risk environment and long gestation periods. Moreover,

given the uncertainty of success in these ventures, it is difficult to raise funds for bridging the

gap between the initial R&D and launch of a commercially viable output in the market. Primarily,

early stage lifesciences companies, which form the backbone of medical innovation, are

struggling to gain investors’ confidence. Today, Indian investors seem to be inclined towards late-

stage strategies due to the illiquid exit market scenario and factors such as aversion to high-risk

models and the underlying long breakeven period in new projects. Also, Indian investors lack

the requisite expertise to understand the importance of these discoveries and transform them

into marketable products.

Another key challenge faced by Indian entrepreneurs is the lack of awareness and success stories

in the bio-IT sector. Firstly, the sector has not witnessed several good exits, which could have

helped in ascertaining the background of an individual entrepreneur or a team. This, in turn, poses

difficulties for an investor to commit to a new project. Also, as the sector is technology-intensive, it is

challenging to formulate a time and tested business model. Finally, the non-compete clause signed

by an entrepreneur after exit prevents him/her from setting up a new venture in the same sector.

Figure 36 : Bio-IT funding innovation cycle facing valley of deaths


R&DPrototype/

Proof of concept

PilotCommerciali-

zation Maturity

Venture Capital Private Equity

Commercialization

Valley of death

Technological

Valley of Death

Expert’s view on the current funding scenario

“I believe Indian Investors do not reciprocate well to the niche biotech sectors. They are not prepared to invest in capital-intensive, long-term innovation- based business models, primarily as there are not enough success stories. The Indian IT industry has reached this level aided by the adoption of successful business models; the bio-IT sector lacks this. Towards this end, an overall innovative culture spurring the investment climate needs to be established to encourage Indian entrepreneurs.

Also, government funding is generally meant for shorter duration which can benefit large firms as they have the financial set-up to simultaneously conduct research across several verticals and a margin to fail (unclear). However, SMEs in the sector need government support in the form of small and ongoing loans as they have limited seed capital for their venture. In addition to early stage funding, companies should be provided later-stage funding for commercialization. Lastly, as the bioinformatics sector falls under the biotech paradigm, various funding programmes are more focused on biotech as a whole; hence, there is a need for commencing a bioinformatics-specific corpus fund”.

Ram Nandkumar Founder & CTO, Metaome


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Recommendations and reforms to bridge the gap

Easy access to adequate financing is very crucial for the sector’s growth. There exists an economic

burden on the relatively nascent bioinformatics industry due to the lack of aid from banks, private

sector, venture capitalists and angel investors. Challenges such as lack of early- and later-stage funding

coupled with dearth of success stories and exit options are the major hurdles. The government, with

support from industry players and academia, must launch initiatives to foster sector awareness and to

deliver successful exit stories in order to drive innovation in the sector. Existing funding issues can be

addressed by formulating a sector-focused fund and promoting a hub & spoke model. We propose

the following policy actions to resolve funding issues of bio–IT companies:

launching early-stage funding schemes to cater to bio-iT start-ups

Start-ups in the bio-IT sector particularly face funding challenges during the early stages of product

development. To assist bio-IT firms in their research objective, policymakers must formulate

schemes like ‘BIG’, the one launched for the broader biotechnology sector. These schemes would

encourage entrepreneurial culture by fostering innovation in the field. Besides, various successful

funding models are adopted by countries worldwide to boost research in innovative technologies.

We can launch some of the below mentioned schemes by incorporating bio-IT-specific components

to better match sector requirements.

Funding models from Asia-Pacific countries that can be replicated

As per the Scientific American magazine’s Annual Worldview Ranking for 2012, Asia-Pacific countries such as Singapore (ranks third), New Zealand (ninth), Australia (10th), Taiwan (21st), South Korea (22nd) and Malaysia (29th) are among the most innovative nations worldwide vis-à-vis India (47).

The world’s third most innovative country, Singapore, is distinguished by a range of government financial programmes, loans and incentives, including:

R&D Incentive for Start-up Enterprises (RISE) Scheme: Cash grant of SUSD20,250 against R&D expenses of at least SUSD150,000 during the initial three years of start-up.

Early-Stage Venture Funding Scheme (EVFS): National Research Foundation (NRF) provides dollar-for-dollar grants up to SUSD10 million to venture capital firms that raise a similar amount from third-party investors for investment in early-stage technology start-ups.

Business Angels Fund (BAF) Scheme: Equity investment scheme where SPRING SEEDS Capital (affiliate of government agency SPRING Singapore) offers co-investments (up to SUSD1.5 million) to approved angel investors to support growth-oriented, innovative start-ups.

Likewise, Australia has launched funds to boost research among home-grown and innovative start-up firms.

Innovation Investment Fund (IIF): The government has been supporting venture capital market through this programme since 1998. IIF is a 10-year innovation fund focused on high-growth companies that require capital to commercialise their research. Through the first two rounds of this fund, the Australian government has invested USD221 million compared with a total funding of USD354 million. In all, the fund has licensed 16 fund managers and assisted more than 100 start-ups.

Medical Research Innovation Fund (MRIF): MRIF provides funding for early-stage companies to set up innovative biotechnology ventures. MRIF comprises USD125 million of government funds with an equivalent amount from the private sector.


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Building strong Vc market with government aid and by enhancing sector awareness

Analysis suggests that availability of a strong VC and angel network is necessary for a sector’s

long-term growth. An established PE/VC market can assist in stimulating innovative start-ups, thus

augmenting market capacity for matching veteran angel investors’ appetite. The major hurdle

facing India’s PE/VC market is restricted understanding of interdisciplinary life sciences owing to

the complex nature of the business. The government can play a key role towards this end by

launching sector awareness programmes in collaboration with industry and academia, thus creating

an attractive investment climate. However, creating a national innovation ecosystem is not sufficient;

funding is equally essential to bring innovative ideas to market.

The uncertainty faced by investors surrounding the long gestation period can be mitigated, to a

certain extent, through the following measures:

• The government should extend continuous support until the idea materialises and business

models seem sustainable. This would boost the commercialisation rate and the sector’s

competitiveness, thus attracting private funding.

• To increase public investment in venture funds focusing on bio–IT companies, the government

can adopt a co-investment model, like New Zealand.

• Team structure is a key differentiating factor for the success of PE/VC in the life sciences

domain in western countries. Typically, the teams comprise PhDs, with hands-on experience in

biotech, alongside finance experts. A similar structure needs to be adopted by Indian VC funds

focused on life sciences, which generally include bankers and business people.

• The government should support micro-funds and investments made by angel investors in bio-

IT companies with equal proportion and offer tax incentives.

Learning from New Zealand’s focused VC model

In 2002, the government launched New Zealand Venture Investment Fund (NZVIF) with an aim to build a robust VC market and enhance the angel network in the country. The fund primarily invests in innovative start-ups in the software, biotechnology and telecommunications & technology sectors. Through NZVIF, the government partners with private investors, and has so far invested a total of USD200 million with the help of two vehicles:

Venture Capital Fund of Funds: This is an investment vehicle with funds under management of USD160 million for investing in high-growth companies. The fund has so far committed USD352 million by teaming with private investors.

Seed Co-investment Fund: This investment vehicle was established in 2005 with an objective to provide early-stage direct funding for start-ups showing strong growth potential. The fund has so far committed USD352 million by teaming with private investors. The USD40 million vehicle functions as a co-investment fund in conjunction with chosen Seed Co-investment Partners. To date, this seed fund has invested nearly USD25 million across 96 seed and early-stage companies.

Since its establishment, of the 146 portfolio companies, 27 fall under the biotechnology sector. In 2013, the government committed another USD60 million towards the programme, which increased the fund’s capacity to USD300 million. Furthermore, NZVIF entered into a partnership with Taiwan’s USD10 billion National Development Fund, with investments in 50 venture capital funds worldwide.


85

listing on stock exchange to achieve public funding and market visibility

Unlike in the West where bio–IT companies are listed on the stock exchange, no single pure–play

bioinformatics company in India trades on the leading bourses. In view of this, the government

launched Emerge and BSESME in 2012; however, the platforms have not been able to attract many

companies. The government must encourage SMEs in the bioinformatics space to launch IPOs. In

addition to offering public equity, which ensures considerable support during the growth phase,

listing on the exchange provides companies with the requisite exposure and visibility coupled with

increasing transparency in their operations. In the long term, such efforts can help to attract foreign

investors and enhance the firm’s acceptance among other private funds. Another added advantage

of listing is availability of exit options, a point strongly favoured by investors.

Although the biotech industry is actively adopting this initiative, its impact and success is yet to be

seen. So far, the initiative has started enabling medium-sized companies to access public funds for

growth. Public funding represents a promising opportunity to the companies in an environment that

lacks venture capitalists willing to invest in early- and mid-stage firms in the life sciences industry.

Learning from Israel’s IPO success

A large number of early-stage life sciences companies trade on the Tel Aviv Stock Exchange (TASE), Israel’s only stock exchange. During 2006, TASE reduced the threshold for R&D companies supporting start-ups with public equity, despite less experience and turnover. Over the years, this has encouraged life sciences companies to get listed on the exchange, resulting in several IPOs, thus augmenting the market appetite. This was further boosted by the launch of the Biomed Index in 2010, which covers Biomed firms with average market value of a minimum of USD14.5 million and 25% public holdings totalling USD7.25 million or more. In 2012, the index gained a significant 40% with 12% returns.

Today, the exchange has 57 life sciences companies, a figure more than that listed on majority of similarly-sized exchanges globally. Furthermore, many of these firms have dual listings in other advanced markets—NASDAQ has more number of Israeli companies in the world with the exception of the US, Canada and China.

establishing sector-focused fund

Indian policymakers should consider launching a bio-IT-focused fund, which would boost the

available risk capital to the companies. This would mitigate the financial crunch faced by the

numerous innovations showcasing potential commercial viability. For successful implementation,

fund managers should have a potent mix, with individuals having in-depth knowledge of the global

life sciences sector alongside experts in the finance and banking domain. After investing, the fund

team should closely assist the management teams of the invested firms to identify and capitalise

on the untapped potential in the sector. The team should offer continuous strategic direction based

on global market insight and help to recognise business opportunities for the portfolio companies.

Also, with constant guidance, the fund can help these companies to improve operational efficiency.

reducing financial burden by adopting Hub & spoke model

State-of-the-art research labs, paid databases and medical libraries are some of the key cost-bearing

requirements for any start-up in the life sciences domain. While some entrepreneurs are able to

utilise the research labs of their respective universities, most of them fail to do so. Towards this

end, bio-incubators can be set up to assist start-ups facing paucity of funds for their infrastructural

requirements. Incubators not only offer infrastructural base (office space, labs and equipment),

but also provide mentorship to early-stage companies. Besides, incubators, various workshops,

seminars and events, offer a networking ground for these firms. Such interactions coupled with

adequate guidance would help new companies to grow and become established players in the

sector. The long-term objective should be deploying a Hub & Spoke model of bio-incubators to

build a large bio-incubator. In this set-up, newer incubators can learn from successful ones.


86

Connectivity

Global Picture

Bio-IT stakeholders worldwide have increased emphasis on connectivity and collaboration. Public

and private organisations in the field are investing in establishing high-bandwidth, collaborative

networks that facilitate sharing of an ever-increasing volume of biological databases and research

work. The development of advanced networks, enabling collaborative research, is gradually bringing

about a paradigm shift in the manner of research. A connected world improves accessibility to free

data and encourages joint development of bioinformatics tools for advanced computing, and would

positively also allow sharing of long-term goals and objectives of varied sectors.

Figure 37 : Global research groups leveraging on high–bandwidth connectivity


GovernmentBodies

Academic

Groups

Industry

Players

Collaboration

Us researchers stay connected by means of internet2

International collaborative networks are largely seen in western countries, with nations such as

China slowly joining the league. In the US, Internet2 is one of the leading platforms offering a

collaborative setting for research and academic communities. The not-for-profit platform also

operates the nation’s largest coast-to-coast network that caters to over 90,000 research and

educational institutions. Currently, the network comprises nearly 250 universities in the US, 78

leading corporations, 70 affiliate members (including government bodies), 39 regional and state

education networks, and more than 65 national networking partners representing over 100

countries. Similarly, ESnet (funded by the US Department of Energy) is another high-bandwidth

connectivity network that allows several scientists, academicians and industry players to collaborate

in the fields of energy, climate science, and the origin of the universe.


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gÉanT, JaneT and egee connecting research in europe

In Europe, EMBL-EBI, the largest public collection of molecular biology databases worldwide, uses

the pan-European GÉANT research network and the UK’s Joint Academic Network (JANET) to

share research output among the biologist community. These networks facilitate swift and safe

diffusion of huge amounts of biological data within its various campuses and to global partners.

The 3.5 million requests are translated to nearly 80 terabytes of data each month. While JANET

supports transfer of information from EMBL-EBI within the UK, GÉANT is responsible for transmitting

data to several national nodes in Europe. Notably, at the end of 2013, the latest version of JANET

was launched. JANET6, specially developed for research and education, is based on 100 Gigabit

Ethernet technology and is scalable up to 8.8 Terabits of capacity. These two networks have

been the backbone of research and innovation in Europe and also proved beneficial for several

other key and major data-heavy research projects undertaken worldwide. In addition to its pan-

European scope, GÉANT has collaborated with the US using Internet2, China through CERNET and

Africa with UbuntuNet.

The European research network scenario is further enhanced by its Enabling Grids for E-Science

(EGEE) project, one of the largest and most significant grid infrastructure projects funded in the

EU. The project is a result of collaborative efforts of 139 institutions across 32 countries planned

in 13 federations. The grid comprises 250+ sites, spanning 50 countries, offering nearly 55,000

CPUs and over 20 Petabytes of data storage. The EGEE network is accessible 24/7, demonstrating

continual workload of close to 150,000 jobs per day.

developing markets opting for the collaborative route

Realizing the necessity for seamless connectivity due to the data heavy nature of research,

Asia-Pacific countries are establishing high-speed global networks for bio-IT. APBioNet is an

effort in this direction. Separately, the Chinese government funded a project, ORIENTplus, along

with the European Commission and European NREN partners. The project is a high capacity

link infrastructure between GÉANT and China to support European and Chinese researchers in

conducting collaborative research. In 2013, with rising demand, the link capacity was quadrupled

to 10 Gbps. Also, the Singaporean government launched SingAREN network in 1997, a high-speed

network assisting advanced R&D activities of user communities across academia groups, research

organisations and industry players worldwide. On similar lines, to connect the research and education

societies in Sub-Saharan Africa with high-speed internet, the European Commission (contributing

80% of the project’s budget), in partnership with its African counterpart (20%), launched a four-year

project, “AfricaConnect”. As part of this project, a high capacity 15,000 km link connecting African

UbuntuNet (the network connecting educational and research centres in Eastern and Southern

Africa) with pan-European GÉANT was set up in May 2011.

Bioinformatics cloud computing – an evolving trend

Traditionally, bioinformatics tools and databases have been working on a web-server model with

institutional infrastructure established on the host network and multiple users connected through

servers. Despite the competency displayed by the current model in terms of ensuring proper

execution of bioinformatics tasks, the provider and user face a number of challenges due to an

inflexible infrastructure design. While, providers cannot scale up their infrastructure in case of rising

data throughput, individual users are unable to enhance their research work by utilising additional

computational resources.

By leveraging a cloud computing technology, the issues can be resolved as bioinformatics tools

can be accessible to all. Currently, few companies such as Amazon Web Services, Microsoft

Azure, Rackspace, Magellan and DIAG provide cloud computing services. In the bio-IT industry,

the government and private players are developing cloud-based applications. Some programmes

developed for the bioinformatics industry, particularly for next-generation sequencing, are Crossbow,

RSD-Cloud, Myrna, and CloudBurst. Leading government bodies are also investing in the field

with EBI recently launching R-Cloud, a scalable user-friendly cloud application catering to R users,


88

scientists and package developers. This represents an opportunity for Indian companies to leverage

their IT excellence and build cloud computing platforms and thereby aid the sector’s growth.

Current status, challenges and recommendations for connectivity in India

Realising the demand for a collective approach involving sharing, disseminating, discussing and

communicating during the research process, several efforts have been made to enhance the

network connectivity infrastructure in the country. Currently, a few major networks – Education

and Research Network (ERNET), TIEN3, GARUDA and BTISNet – are assisting scientific research

in India. These networks offer internet access to the associated academic institutions, government

agencies and private stakeholders.

intra-country networks

The National Knowledge Network (NKN) was launched in 2010 to offer high-speed connectivity

to educational institutes and research centres. The multi-gigagbit (multiples of 10Gbit/s) platform

connecting 7 super nodes, 24 nodes and more than 1,000 institutions (education and research

centres) identified bioinformatics as one of its key focus areas. The project aims to link more than

1,500 Indian institutes with high bandwidth by March 2014, thus assisting in the development of

robust e-Infrastructure in India.

GARUDA, the first national grid initiative, was undertaken by C-DAC to promote collaboration

among academic groups, scientific and research communities through NKN. The grid, based on

the proof-of-concept initiative, links 45 institutions across 17 cities with an aim of achieving scientific

and technological excellence.

Apart from general frameworks assisting the Indian research community as a whole, DBT has

launched BTISnet, a network focused on bioinformatics. The network facilitates sharing of

bioinformatics databases and software tools stored on its individual node. BITSnet has grown to

65 nodes (institutions and universities) across India and the user community is as large as 12,000

individuals. Furthermore, BTISnet has supported the setting-up of BioGrid India, a large bandwidth

and high-speed grid connecting 11 institutions. The network has not only helped in eliminating

duplicate work but also empowered regional centres to innovate and develop customised

bioinformatics services.

interconnecting e-infrastructure between nations

ERNET India was the first integrated effort for combining research and education communities by

leveraging the benefits of information and communications technology. The autonomous set-up

was launched by DeitY in 1998. The scope of ERNET is not restricted to offering connectivity; it

also includes consultancy, project management and training in addition to other allied services

such as web hosting, e-mail, video conferencing, domain registration and CUG services. Currently,

the network caters to more than 1,300 institutions across health, agriculture, education and

science & technology sectors. Furthermore, it was nominated as the nodal network for India by the

government; it was connected to the pan-European GEANT over 2006–10 through a high-speed

connection. Currently, ERNET-GEANT connectivity has been shifted to the Trans Eurasia Information

Network (TEIN3).

Benefits of TIEN3, the largest research and education network across the globe, were extended

to India in 2008. The network interconnects academia groups and research institutes functioning

across China, India, Indonesia, Japan, Korea, Malaysia, Nepal, Pakistan, the Philippines, Singapore,

Sri Lanka, Thailand, Vietnam, Australia, Bangladesh and most recently Cambodia. Also, it has

established connection with the GÉANT network. This led to huge prospects for Indian researchers

in terms of collaborating with their counterparts in Europe and rest of the world.

To further bolster the EU-India collaboration, another project EU-IndiaGrid was launched. Co-funded

by the European Commission, the project has played an important role in bridging the distance


89

and enhancing the research interoperability between the two nations. It entailed establishment of

interoperability between the EGEE and Indian platforms: GARUDA and the Department of Atomic

Energy’s Grid Project. Success of the EU-IndiaGrid led to the launch of EU-IndiaGrid2, which aimed

at further strengthening the collaborative link.

Figure 38 : EU-IndiaGrid


EU-India Grid 2

Strengthen collaboration among Europe’s and India’s e-infrastructure for boosting

EU-India relationship in e-Science Encourage certain specific user

communities to exploit the existing grid infrastructure in areas strategic for EU Indian collaboration

Encourage India’s co-operation with other EU initiatives across Asia and globally

Formulate a sustainable framework to use of

e-infrastructures across the two nations with the support

of action plans, conferences & workshops

launching high-speed connectivity networks

Although India has a strong network framework enhancing the collaborative efforts of its researchers,

the country still needs to improve the internet infrastructure. Unlike the US and Europe that display

an internet speed of at least 10Gbps, India is connected to the global networks of GÉANT and TEIN

with a 2.5Gbps link. Furthermore, research works conducted under the supervision of different

government bodies are not very well connected within themselves or with the industry.

High capacity networks and advanced internet architecture are required to transfer massive

volumes of data originating from research activities. At the same time, complexities and protocols

for the networking environment should be as transparent as possible for users’ convenience. In line

with this, major initiatives need to be undertaken by the responsible communities.

Compared to other geographies, the internet speed capacity in India is relatively low. To

completely exploit the bio-potential driven by data heavy research, a strong internet infrastructure

needs to be in place. With high-speed networking, Indian researchers would be able to connect

flawlessly with research institutions within the country and other global centres. This would

not only boost cooperative research activities between the organisations but also enhance

the skill sets of participating researchers. Real-time sharing of research output would lead to a

faster project turnaround.


91

Conclusion

Bio-IT has proved to be a dominant tool for bolstering advanced scientific research and offering

secure, efficient, patient-centric and equitable healthcare services worldwide. Although relatively

a late entrant, the Indian bio-IT sector has been growing at a tremendous pace over the past few

years. While the bioinformatics sector was pegged at USD55.0 million as of 2012–13, the health

informatics market was valued at USD381.3 million in 2012.

The robust pace at which bioinformatics sector has been growing has its foundation in the BTISnet

launched in 1986–87 by the DBT. This favourable groundwork established by DBT, was buoyed by

inputs from several government bodies such as DeitY, ICMR, and DST. On similar lines, NHP was

the driving force for encouraging the health informatics sector, which then received strong support

from public bodies such as ISRO, CSIR and MoHFW. The public sector’s efforts were emulated

by private players seeking to benefit from the huge business opportunity existing in the Indian

healthcare delivery model. In addition, a number of strategic collaborations led by the private

and public sectors further bolstered the Indian bio-IT market. The foundation established by DBT

and its allied organisations and strengthened by private participation augurs well for the sector’s

anticipated growth outlook.

The momentum is expected to be sustained, as bioinformatics would continue to benefit from

plunging sequencing costs and increased global drug R&D. Likewise, the health informatics sector

is set to attract rising interest from the government and private sector. Health informatics’ potential in

aiding inclusive healthcare, enabling efficient public health management and improving the health

delivery process are some of the prime factors contributing to bio-IT’s growth. Moreover, India,

with its IT and biotechnology expertise as well as cost advantage, English-speaking workforce and

concerted efforts from academia groups, the government and industry players, has the potential to

considerably transform the bio-IT sector and establish its mark on the global map. The Indian bio-IT

sector is expected to reach USD10.2 billion by 2025.

To fully capitalise on the growth outlook, there is a necessity to launch a transparent and

streamlined long-term policy framework along with the efforts outlined on the infrastructure (human

resource, funding and connectivity) front. Globally, competitive educational infrastructure, driven

Conclusion

92

by an updated curriculum, multidisciplinary courses and international collaborations, supported by

virtual classrooms and joint programmes are the key metrics required for India’s bio-IT foundation.

Furthermore, targeted funds from both public and private parties supported by increasing

awareness of the sector’s potential is a prerequisite for taking the industry to the next level. These

efforts along with well-connected research activities, led by high-bandwidth connectivity, has the

potential to further buoy the collaborative environment among indigenous stakeholders besides

aiding international linkages.

Recommendations mentioned above are critical for capitalising upon the bio-IT sector’s growth

prospects and enabling India’s journey towards a bio economy. These recommendations are based

on primary and secondary industry analysis and successful models followed in the west and other

developing economies. The information presents a strong argument that India can also leverage bio-

IT for improving its healthcare system and eliminating inequality. All said, to fully capture the potential

advantages of bio-IT, determined and continual efforts would be required in the coming years.


93

Annexures

Annexure 1: Introduction to India’s healthcare needs

Annexure 2: Company Profiles of Major Players in India

Annexures

94

Status of healthcare in India

India’s healthcare sector caters to a complex set of needs; on one hand is the low-income population

that cannot afford advanced healthcare services; on the other, the high-income class expects (and is

willing to spend) world-class facilities. Although catering to the healthcare needs of a vast population

is a challenge, it represents a substantial opportunity for public and private sector players. They can

play a vital part in assisting this evolution. Supply-side drivers such as increasing cases of infectious

and lifestyle diseases, coupled with demand-side drivers such as higher spending power and boost

in medical tourism are stimulating demand for healthcare services.

The domestic healthcare industry, estimated to be worth ~USD78.6 billion in 2012, is expanding

at a robust rate (CAGR of 15.0% during 2008–12)86. Yet, the progress is subpar compared to the

advanced and BRICS nations. In fact, health indicators reflect India‘s healthcare status is only

superior to that of sub-Saharan Africa. Notably, among 186 countries, India has a poor ranking of 136

on the human development index (HDI)87. Also, an average Indian’s life expectancy at birth (which

is 65 years) and at the age of 60 (17 years) is two years below the BRICS average. In terms of infant

mortality rate, the probability of dying by the age of one is as high as 47 per 1,000 births in India

vis-à-vis 24 in BRICS and a meagre 4 in advanced nations. This indicates despite the investments

and initiatives undertaken in the healthcare sector, the picture is not positive.

Figure 39 : Comparison of healthcare status in India and other developed and developing economies

Source: World Heath Statistics 2013 (based on 2010 data)

Developed Economies Developing Economies

Indicator Year India US UK Japan Brazil Russia ChinaSouth Africa

Human Development Index 2012 136 3 26 10 85 55 101 121

Life expectancy at birth (years) 2011 65 75 76 79 67 69 69 63

Life expectancy at 60 (years) 2011 17 23 24 26 21 18 20 17

Infant mortality rate (probability of dying by age 1 per 1000 live births)

2011 47 6 4 2 14 10 13 35

Maternal mortality rate (per 100000 births)

2010 200 21 12 5 56 34 37 300

Adult mortality rate (probability of dying between 15 and 60 years of age per 1000 live births)

2011 203 104 74 65 151 241 97 441

India’s healthcare sector is segmented into five divisions: Hospitals, Pharmaceuticals, Diagnostics,

Medical Equipment and Medical Insurance. A brief description of each of these is mentioned below.

Hospitals contribute 70% to total healthcare revenues

Of the five segments, hospitals dominate the healthcare industry’s revenues. Private and public

hospitals account for more than 70% of the sector’s revenue; of this, private hospitals alone constitute

more than three-fourth. This could be ascribed to the rising demand for hospital services, with each

economic class of the society seeking improved quality and standard of products and services.

With private and public sectors making significant investments to boost healthcare infrastructure,

notable progress has been witnessed in the setting up of new hospitals and educational institutions

in the last few years. The number of government hospitals across India aggregates 35,416, of

which, 26,604 are located in rural areas and the remaining in urban areas88. Furthermore, the

number of hospitals under the Department of Ayurveda, Yoga & Naturopathy, Unani, Siddha and

86 Healthcare Industry, by IBEF, 201287 Human Development Report 2013, United Nations Development Programme, 201388 The National Health Profile by Central Bureau of Health Intelligence, 2012

Annexure 1: Introduction to India’s healthcare needs


95

Homoeopathy (AYUSH) stood at 3,155 as of 1 April 201289. Also, as of March 2012, the number

of sub-centres and primary healthcare centres were 148,366 and 24,049, respectively, up from

146,026 and 23,236 in 2005. The number of community healthcare centres totalled 4,833 vis-à-vis

3,346 during the same period90.

Figure 40 : Healthcare revenues – USD78.6bn in 2012

Source: Fortis Corporate Presentation August 2012

45.0

51.7

59.5

68.4

78.6

2008 2009 2010 2011e 2012e

CAGR 15.0%

Figure 41 : Hospitals command largest share (2012)

Source: IBEF

71%

13%

9%

4% 3%

Hospitals Pharmaceuticals Medical Equipments

Health Insurance Diagnostics

Going forward, private hospitals are set to capitalise on growth opportunities in the healthcare

industry due to inadequate facilities in government hospitals. Private hospitals are expected to

account for 80–85% of the USD86.0 billion investments by 202591. Furthermore, interest from

private equity and venture capital funds, domestic and international financial institutions, and banks

is expected to increase.

Fragmented pharmaceutical segment dominated by generics

In terms of volume of production, India’s pharmaceutical sector is the third largest in the world. The

sector is highly fragmented, with nearly 24,000 companies having around 250 large manufacturing

units (market share of 70%) in the organised category. Also, approximately 8,000 small-scale units

and five central public sector units operate in the sector92.

Currently, generics account for nearly 90% of the market. Most domestic firms are generic

manufacturers of bulk drugs or formulations. India is the leading exporter of generic drugs. The

country is home to more than 120 US FDA-approved and 84 UK MHRA-approved manufacturing

facilities93. Also, in 2012, Indian pharmaceutical firms filed 417 Drug Master Files (DMFs) with the US

FDA, an increase of 3.2% y-o-y94. India is set to further benefit from the decision of governments

across the US, UK and Japan to increase focus on generic drugs.

Though India scores well on the DMF filings and FDA-approved production facilities (outside the

US), an unfavourable patent rights scenario fails to assist the country’s run for new drug targets. The

novel drug scenario in India remains poor, with just two drugs developed entirely so far – Cadila

Healthcare’s Lipaglyn (lowers cholesterol in diabetic patients and during glycemic control) and

Biocon’s Alzumab (for treating psoriasis). The prime reason is the high cost incurred during drug

development and the old patent regime (2005) lacking the long-term essential protection rights.

Also, the biggest question facing pharmaceutical companies is whether or not the Indian regulatory

89 http://www.pib.nic.in/archieve/others/2013/aug/d2013082002.pdf90 Rural Health Statistics in India 2012, by Ministry of Health and Family Welfare Government of India,

201291 Indian Healthcare Report by MEG Strat Consulting, May 201292 A Brief Report on Pharmaceutical Industry in India, by Corporate Catalyst India, 201393 http://www.investindia.gov.in/?q=pharmaceuticals-sector94 http://www.pharmabiz.com/NewsDetails.aspx?aid=75539&sid=1

Annexures

96

body would allow the high development cost to be transferred to end users. However, in the past

few years, Indian pharmaceutical companies have started realising the short-lived nature of reverse

engineering and have increased their investments in R&D. Firms traditionally investing just around

2% of their turnover on R&D increased the spending to nearly 8% during FY13. However, the figure

still remains below the 12% investments undertaken by western counterparts.

Figure 42 : India – home to highest FDA approved plants*

Source: IBEF – Pharmaceutical Industry,

March 2013; *except the US

5

8

10

25

27

55

150

0 50 100 150 200

Hungary

Israel

Taiwan

Spain

China

Italy

India

Figure 43 : Rise in the number of DMFs filed by India

Source: IBEF – Pharmabiz

417404

311

271

2012201120102009

India has strengthened its global footprint in vaccine production due to the concerted efforts of

public and private players. The country exports vaccines to global organisations such as Gates

Foundation, Clinton Foundation, United Nations Childrens’ Fund (UNICEF) and GAVI Alliance.

UNICEF, which is said to cater to the vaccination needs of over 140 countries (40% of the global

demand), accounts for 70% of vaccines manufactured in India95.

Medical equipment segment accounts for 9% of total revenues

The medical equipment segment is dominated by international players. During 2008–12, the

segment registered a CAGR of 37% to USD7.1 billion. An increase in the number of hospitals and rising

access to advanced technologies has bolstered the sector. Nearly 75% of the medical technology

equipment is either imported or manufactured by international companies; surprisingly, around

60% of the medical products manufactured in India are exported96. Some key categories under

which India imports are imaging technologies, pacemakers, orthopaedic & prosthetic products,

breathing & respiration apparatus and dental surgical instruments, while exports mainly constitute

low-technology equipment. The industry is highly fragmented, with majority of the domestic players

following a low-price, high-production strategy. On the other hand, international players focus on

market creation through innovation rather than mere market capture.

Rise in health insurance penetration

The health insurance market has flourished with rising awareness among people, increase in

healthcare costs and disposable income, government initiatives, and an evolving regulatory

climate. Moreover, the burden of new diseases, coupled with inadequate government funding, is

further raising the demand for health insurance coverage among Indians. It is one of the fastest

growing non-life insurance segments in the country. The industry expanded at a CAGR of 32%

over FY07–12. Health insurance penetration, as a percentage of GDP, rose to ~0.17% in 2012–1397

from 0.08% in 2006–07. Moreover, severe competition among non-life insurance companies has

supported the decline in individual premiums, thus ensuring affordability of insurance coverage in

India. However, overall gross health insurance premiums stood at USD3.0 billion, representing a

95 http://embassyofindiaukraine.in/speech_detail.php?id=296 Medical Technology Industry in India by Deloitte, July 201097 IRDA and annual report of Apollo Hospitals and Max India FY13, 2013


97

CAGR of 32.5% over 2006–12, supported by increasing penetration.

Figure 44 : Health insurance market size (USD m) in India

Source: IBEF

709

1,2741,443

1,752

2,459

2,774

FY07 FY08 FY09 FY10 FY11 FY12

CAGR 31.4%

Figure 45 : Growth in health insurance premium (USD bn)

Source: IBEF

0.7

1.21.3

1.5

2.1

3.0

FY07 FY08 FY09 FY10 FY11 FY12

CAGR 32.5%

India offers immense opportunities in healthcare insurance as less than 15% of the total population

has any health insurance coverage vis-à-vis advanced economies, where penetration is more than

80%. With an increase in government health schemes for the poor (Aryogyashree, National Rural

Health Mission, among others), a large segment of the population is expected to be covered by

health insurance. The share of population having medical insurance is expected to rise to 20% by

2015 from the current 2%98.

Diagnostics segment primarily comprises laboratories

India’s diagnostics market is expected to register significant growth, with increasing vulnerability to

diseases and their early detection. The country has more than 100,000 diagnostics laboratories. A

large number of unorganised players operate at the regional or city level. Samples tested on a daily

basis vary from 3,000 for major labs to 50–100 for those in smaller towns. Haematology, reagents,

molecular diagnostics and specialty diagnostics are the main growth drivers for the segment.

Molecular diagnostics has the highest market share of 30–40%99.

Figure 46 : Health insurance market size (USD m) in India

Source: Equentis Capital

45

79

160

0

20

40

60

80

100

120

140

160

180

2008 2012 2017

Figure 47 : Growth in lifestyle diseases

Source: ABLE

3.1%

3.0

%

1.3%

0.3

%

4.9

%

3.7

%

2.7

%

0.3

%

0.0%

1.0%

2.0%

3.0%

4.0%

5.0%

6.0%

Cardiac Daibeties Obesity Cancer

2005 2015

98 Healthcare Report, by IBEF, 201399 ehealth.eletsonline.com/2012/12/indian-diagnostics-a-leap-in-the-dark/

Annexures

98

Healthcare to expand at a CAGR of 12.6% over 2012–17e

The healthcare industry in India is set to grow at a significant pace and reach USD160 billion by

2017100. Factors such as increasing population, improved standards of living and rising disposable

income have enhanced the need for additional and superior quality healthcare facilities in India. This

could be primarily ascribed to the population (currently pegged at 1.2 billion), which is increasing

at an annual rate of 2% per year. The per capita income is also estimated to record a CAGR of 7.1%

over 2012–18. Furthermore, rise in contagious, chronic degenerative and lifestyle-related diseases

alongside expanding awareness about personal healthcare are some reasons supporting the growth

estimate. Interestingly, lifestyle-based illnesses were expected to account for 48% of the inpatient

revenue in 2013101. Among segments, medical tourism, insurance, telemedicine, digital health and

medical equipment are some key areas where growth opportunities exist in the medium term.

Development goals and initiatives undertaken by India

The goal of each country towards its healthcare system is to improve access, boost quality and

trim costs in order to facilitate provision of adequate healthcare facilities. India faces the dual issue

of providing affordable healthcare to the poor alongside superior quality services to the rich. Also,

similar to other emerging nations, the country has to concurrently act upon communicable and non–

communicable diseases. In line with this, development goals such as the National Health Policy

(NHP) (1983 and 2002) and Millennium Development Goals (MDG) (1992) have been established with

long-term goals. These have helped develop India’s health ecosystem in certain areas. While some

goals have been fulfilled over the years, several areas have not yielded the anticipated results.

National Health Policy (NHP)

Formulated in 1983 (modified in 2002), NHP is a time-bound set-up to develop a strong primary

healthcare services network in India. The policy’s holistic framework covers issues such as funding,

organisational restructuring and access to equitable healthcare. Furthermore, the objective

is to eliminate the disease burden caused by certain illnesses such as cancer, tuberculosis

and malaria in India.

The policy aims to achieve the following goals over 2005–15.

Figure 48 : NHP goals

Source: National Health Policy, 2002

Eradicate dieseases such as polio

and leprosy

Establish a comprehensive system

of surveillance, National Health

Accounts, and Health Statistics

Achieve zero level

growth in cases of

HIV/AIDS

Eliminate Kala Azar

Reduce loss of life caused due to

TB, malaria and other vector &

water-borne diseases by 50%,

blindness prevalence to 0.5%, IMR

to 30/1000, and MMR to 100/Lakh

Increase utilisation of public health

facilities from less than 20 to more

than 75%

Eliminate lymphatic

filariasis

2005 2007 2010 2015

100 Equentis Capital, December 2013101 Investor Presentation, by Apollo Hospitals, 2013


99

To achieve the goals mentioned above, the following objectives were formulated:

• Establishing adequate level of health services for the Indian populace;

• Providing decentralised services to the public health system through advancements in existing

infrastructure;

• Advocating public-private partnerships;

• Promoting equitable access to health services across India;

• Encouraging private sector participation for superior quality services;

• Giving utmost priority to the prevention of diseases and ensuring first-line curative measures;

and

• Emphasise wise drugs usage and offer access to dependable systems of traditional medicine.

Millennium Development Goals (MDG)

India became a signatory to the Millennium Development Goals (MDG) along with 188 other countries

in 2000. The significance of healthcare is reflected by the fact that three of the eight goals, six of

the 21 targets, and 18 of the 60 indicators are related to the sector. Healthcare goals revolve around

reduction in infant mortality rate, improvement in maternal health, and prevention of HIV/AIDS,

malaria and other diseases. These goals are expected to be achieved by 2015. Furthermore, India

signed the Alma Ata Declaration, which pledged health access to all citizens by 2000.

Brief description of the targets and the recent status are mentioned below.

Figure 49 : MDG goals

Source: Millennium Development Goals; World Health Statistics

Child mortality rate

Target: Reduce Under-Five Mortality

Rate (U5MR) to less than 39/1000

live births over 1990–2015

Status: U5MR was 61/1000 live births

in 2011

Way foreward: Average decline of

11% each year during 2012-15

required to acheive MDG-4

Maternal mortality rate

Target: Reduce Maternal Mortality

Rate (MMR) to 150/100,000 live

births over 1990-2015

Status: MMR was 200/100,000 live

births in 2010

Way foreward: Average decline of

6.8% each year during 2012–15

required to acheive MDG-5

Cause-specific mortality rate

Target: Halt the rise in and reverse

the spread of HIV/AIDS, malaria

and tuberculosis

Status: HIV/AIDS: new annual HIV

infections declined by 58% during

2000–11, Malaria: Incidence down

to 1.1/1000 cases in 2011, and

Tuberculosis: Prevalence down

57.5% over 2000-09

Annexures

100

India has made noteworthy progress in healthcare over the years; diseases such as smallpox, polio

and guinea worms have been eradicated completely, while leprosy, kala azar, and filariasis are

expected to be eliminated in the near future. In addition, fertility and infant mortality rates have

declined significantly. Various programmes, such as the National Rural Health Mission (NRHM) and

Rashtriya Swastya Bima Yojana (RSBY), have aided the accomplishment of these targets.

In line with NHP 2002, NRHM was launched in 2005. It is the first ever health programme initiative

focused on improving the condition and status of healthcare facilities in India, specifically rural

areas. The initiative is a mix of pre-emptive, restorative and rehabilitative services delivered with

the support of various co-operative measures. The model’s framework functions with the active

involvement of local rural governments (Panchayats) for its sustainability. Programmes targeting

immunisation, tuberculosis and cancer control, and leprosy elimination, among others, have been

incorporated under the NRHM. The framework also aims at revitalising and integrating local health

customs of medicine – Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homoeopathy (AYUSH)

– into the public health system.

The mission, with a special focus on 18 states, seeks to augment public health expenditure, lower

the regional disparity in terms of infrastructure, integrate resources and bring various organisations

and vertical national programmes under one aegis, among others. The mission also facilitates

strengthening of the National, State and District Health Missions. At the village level, the government

has adopted the Accredited Social Health Activist (ASHA) model.

Figure 50 : NHRM functions

Source: National Health Mission

Levels Entities Representatives Functions

Village Village Health & Sanitation Samiti (local government body)

Panchayat, ASHA and community health Volunteers,

Rogi Kalyan Samiti manages public hospitals

District District Health Mission District Health Head, relevant departments, NGOs, private professionals, etc.

Controls, guides and manages all public health institutions in district CHCs, PHCs & SCs

State State Health Mission State Chief Minister, State Health Minister, State Health Secretary, representatives of relevant departments, NGOs and private professionals;

Central National Mission Steering Group

Union Minister for Health & Family Welfare, Deputy Chairman of the Planning Commission, Ministers of the Panchayati Raj, Rural Development, Human Resource Development and Public Health professionals

Provides policy support and guidance to the Mission

Empowered Programme Committee serving as Executive Body of the Mission

Secretary, Health & Family Welfare

Standing Mentoring Group Guides and oversees the implementation of ASHA initiatives

Task Groups Selected for time-bound tasks

Rashtriya Swastya Bima Yojana (RSBY)

It is a national health insurance scheme launched by the Ministry of Labour & Employment, catering

to the population in the below poverty line (BPL) in the unorganised sector. Under the scheme,

an insured BPL family (couple and three children) is covered for INR30,000 (USD513.6) at a cost


101

INR30 (USD0.5) per annum. In FY13, over 1.75 million new RSBY cards were issued102. This state-run

insurance plan provides cashless insurance for hospitalisation across public and private hospitals

with the help of third-party administrators and technology. So far, with more than 30 million families

covered across India, it is one of the largest health insurance schemes worldwide. Owing to the

tremendous success, in December 2013, the state government proposed to broaden the horizon

of RSBY to incorporate all of the BPL families in the state.

Budgetary outlay under the five-year plan

In the past decade, Government of India introduced several reforms under the 11th and 12th Five-Year

plans to improve healthcare conditions. Under the 12th Five-Year Plan, the Planning Commission

allocated USD55 billion to the Ministry of Health and Family Welfare which is about 3x the actual

expenditure under the 11th Five-Year Plan103. Public healthcare expenditure, as a percentage of GDP,

has been gradually improving, from 0.9% during the 10th Five-Year Plan to 1.04% during the 11th

Plan104. The 12th Five-Year Plan, which primarily focuses on inclusive growth, emphasised on better

healthcare coverage and quality. Government expenditure on low-cost healthcare is expected to

rise to 2.5% of GDP during the 12th Five-Year Plan (2012–17).

Figure 51 : Allocation under the 12th Five-Year Plan (USD55.1 bn) vis-à-vis 11th Five-Year Plan (USD19.8 bn)

Source: Planning Commission

Department of health and family welfare AYUSH Department of health research Aids control

Budget almost tripled

18.4

0.7 0.40.311th Five Year Plan

49.4

1.81.8 2.1

12th Five Year Plan

An expansion in budgetary allocations is supported by positive fiscal (tariff and non-tariff) reforms

such as: (i) income tax exemption to hospitals (=>100 beds) set up in rural areas for the initial five

years to improve healthcare infrastructure; (ii) reduction in import duty on medical equipment to

5–8% from 25% earlier; (iii) lowering of the customs duty on medical, surgical, dental and veterinary

furniture, among others, to 8% from 16%; (iv) excise duty exemption on specific personal medical

aids such as crutches, wheel-chairs, walking frames and artificial limbs as well as devices such as

talking books, Braille computer terminals; and (v) implementation of the 40% depreciation limit on

import of medical equipment.

Challenges denting India’s healthcare growth

Mediocre performance of the healthcare sector can be majorly ascribed to the underlying

infrastructure bottlenecks and low healthcare spending. Factors negatively impacting the

sector’s performance include improvements across health indicators (HDI, mortality rates and life

expectancy), physical infrastructure (beds, hospitals and medical equipment), health insurance

102 http://www.thehindu.com/todays-paper/tp-national/tp-karnataka/rashtriya-swasthya-bima-yojana-

for-bpl-families-too/article4893290.ece103 Healthcare Report, by IBEF, 2013104 Twelfth Five Year Plan (2012–2017)Social Sectors, by Planning Commission, 2012

Annexures

102

(penetration levels), human capital (doctors, nurses and physicians) and healthcare expenditure (as

a percentage of GDP).

Separately, lack of novel drugs being developed in the country, despite a large talent pool, is one of

the most significant drawbacks impacting the sector’s success in the long term. Also, India faces the

dual burden of communicable and non-communicable diseases unlike developed countries, which

have to deal with it on a sequential basis. Furthermore, considering the large rural Indian populace

(73% of Indians live in rural areas and 26.1% is BPL105), catering to the high demand for accessible

and rationally priced healthcare continues to be a challenge.

Low levels of public healthcare spending

The primary challenge threatening India’s healthcare system is the low level of spending on medical,

public health and family welfare activities. As a percentage of GDP, India’s healthcare spending is

less than half of that worldwide. Healthcare spending stood at 3.7% of GDP vis-à-vis the BRICS

average of 6.6% and much below the global average of 9.2%106. Moreover, when evaluated on the

basis of the public-private contribution break-up, healthcare spending reflects a distorted picture.

Low public spending, leading to poor quality of preventive and curative treatments, accentuates the

deprived health conditions of the population. Inadequacy in public health provision has increased

the need for private health providers, resulting in high Out-of-Pocket (OOP) spending. The private

sector’s contribution to the healthcare sector in India hovers around 72% (among the highest

worldwide in percentage terms), while that for public spending is around 32 percentage points

lower relative to the global median (pegged at 60.8%)107. Availability of funds is also skewed in some

low-income states that further perpetuates the inequitable funding scenario.

Figure 52 : Low spending on healthcare in India

Source: World Heath Statistics 2013

(based on 2010 data)

3.7%5.0%

6.5% 6.6%

9.2% 8.7% 9.0% 9.6%

17.6%

Ind

ia

Ch

ina

Ru

ssia

BR

ICS

avg

Glo

ba

l avg SA

Bra

zil

UK

US

as % of GDP

Figure 53 : Skewed picture of public-private spending

Source: World Heath Statistics 2013

(based on 2010 data)

47

%

62

%

54

%

29

%

47

% 53

%

84

%

59

%

53

%

38

% 46

%

71%

53

%

47

%

16%

41%

Bra

zil

Ru

ssia

Ch

ina

Ind

ia

BR

ICS

avg US

UK

Glo

ba

la

vg

Public Private

On a per capita basis, in terms of USD (at an average exchange rate conversion) and Purchasing

Power Parity (PPP), healthcare spending in India is among the lowest in the world. Per capita total

healthcare expenditure, on an average exchange rate basis, stood at USD51, nearly 84% below the

global average. India’s PPP of USD126 is ~25% below the global average of USD496108.

A paradox – India leverages drug discovery skills for global majors, but fails to utilise it internally

The global drug discovery process is undertaken through computational methodologies. Several

105 Healthcare Infrastructure and Services Financing in India, by PwC, 2012106 World Heath Statistics 2013 (based on 2010 data)107 World Heath Statistics 2013 (based on 2010 data)108 World Heath Statistics 2013 (based on 2010 data)


103

Indian bioinformatics companies generate business by assisting their global counterparts in the

drug development process at a lower cost. However, it is a paradox that Indian pharmaceutical

firms have not leveraged the competent bioinformatics climate for inventing novel drugs so far.

Currently, a few domestic companies, such as Piramal Life Sciences, Glenmark and Sun Pharma,

have explored the possibility of new drug research with just 70–80 molecules in the pipeline; of

these, more than 46–48 molecules are in the early clinical stages. To significantly raise the number

and attract more players into new drug development, it is necessary to overcome the long gestation

period and cost hurdle.

Interestingly, of the 1,001 patents granted between April 2010 and March 2013, more than 75% were

offered to foreign drug manufacturers such as Pfizer Inc., Novartis AG and F Hoffmann La Roche

Ltd109. However, the negative IPR ruling reflected in the recent patent application denial for Novartis’

Glivec (drug for leukaemia) can have a ripple effect on innovation and investments in the Indian

pharmaceutical sector. Also, with the burden of non-communicable diseases rising at a high rate, it

is essential for Indian companies to carry out the much needed research to provide patented drugs

at affordable rates. Globally, the age-standardised mortality rate for communicable diseases has

been pegged at 230, while that for non-communicable is 573 per 100,000 people. With increasing

research and fast tracking of drug discovery processes, high income economies were able to bring

down the figure for communicable diseases to 31 per 100,000 in 2010. At the same time, lack of

access to patented drugs at affordable rates led to a rise in mortality across emerging nations, with

low income groups reporting 636 deaths per 100,000 people as of 2010110.

Figure 54 : Low spending on healthcare in India

Source: WHO Statistics 2010

15%

56%

29%

1990

Injuries

Communicable

Non-communicable

19%

24%57%

2020

Inadequate physical infrastructure hampers the reach of healthcare providers

India faces persistent dearth of healthcare infrastructure, particularly in rural areas and Tier II and

Tier III cities. Public healthcare facilities offer basic services despite the launch of numerous funding

programmes. With the exception of a few facilities, most public entities remain disorganised,

inefficiently managed and staffed, and have obsolete medical equipment. Currently, government

hospitals in India have a bed capacity of 784,940, translating into an average of 1,512 patients

served per hospital bed. India has 0.9 beds per 1000 people, well below the global average of 2.9

beds111. The number of facilities currently available to support the growing population is insufficient.

An estimated 450,000 additional hospital beds would be required by 2014. However, this seems

difficult considering 40% of the target is not yet achieved. Also, demand for healthcare centres in

rural areas falls short of 9,814.

109 Pharma Spectrum, by Organisation of Pharmaceutical Producers of India, 2013110 WHO statistics 2010111 World Health statistics, 2012

Annexures

104

By 2025, India’s requirements are expected to be as follows:

• New beds totalling 1.75 million to achieve the target of two beds per 1000 people; current

capacity of 0.9 beds is 45% of the actual requirement;

• Nearly 700,000 additional doctors to achieve the target of one doctor per 1000 people; current

capacity of 0.65 doctors is 65% of the actual requirement; and

• Approximately 1,600,000 additional nurses required to retain the current doctor to nurse

ratio of 1:2.2.

Developed Economies Developing Economies

Indicator Year India US UK Japan Brazil Russia China South

Africa

Hospital bed

density (per 10,000

population)

2005–

2012

9 30 30 137 23 97 39 NA

Doctor density (per

10,000 population)

2012 6.5 24 28 21 18 43 15 8

Births attended

by skilled health

personnel (percent)

2010 58 99 NA 100 99 100 96 NA

Figure 55 : Infrastructure and human capital

Source: World Heath Statistics 2013 (based on 2010 data)

Apart from the deterioration in physical infrastructure, India faces a huge shortage of trained medical

professionals, especially doctors, nurses and paramedics, willing to practice in rural areas that have

limited access to patient care. The number of healthcare professionals in India stands at 24.1 per

100,000 people, below the minimum required level of 25. The situation is worse in rural India; of the

total demand for doctors at community health centres (19,236), just 36% has been met. Poor quality

of professionals qualifying from not-so-recognised institutions has further aggravated the situation.

Rural India most affected due to low healthcare penetration

Low public contribution renders India’s healthcare sector highly unbalanced in terms of quality of

services across various income groups. In the current scenario, 78% of the healthcare cost is borne

by patients, of which drugs constitute 72%. The government aims to reverse this scenario with

the implementation of a new plan under which 350 essential drugs would be available for free to

nearly 52% of the population by April 2017 . The expense incurred to provide this facility would be

spilt between the centre and state governments in a ratio of 3:1. To further overcome this disparity,

Government of India has earmarked USD62.8 billion for healthcare under the 12th Five-Year Plan.

Just 25% of the total health infrastructure in India, including doctors, specialists and other health

resources, is available in rural areas, where more than 70% of the population resides. Thus, it is

difficult for the rural population to avail quality healthcare services. Some statistics highlighting the

chronic shortage of healthcare facilities in rural India are mentioned below.

• Availability of doctors in rural regions is six times below that in urban areas.

• Availability of beds in rural areas is 15 times lower than that in urban areas.

• Just 34% of the total rural population has access to preventive medicines.

• To receive medical treatment, 31% of the rural population needs to travel over 30 km.

• Around 40% of the rural population suffers from infectious diseases vis-à-vis 23.5%

in urban India.

Annexure 2: Company Profiles of Major Players in IndiaCompany name Database

providersData

mining and generation

Healthcare-IT

Strand Life Sciences Pvt. Ltd.

Ocimum Biosolutions (India) Ltd

Molecular Connections P Ltd

InterpretOmics

Jubilant Biosys Ltd

Novo Informatics

Wipro

TCS

Mahindra Satyam

Infosys

Institute of Bioinformatics

Eminent Biosciences

GVK Biosciences Private Limited

BioAxis DNA Research Centre

Xinnovem

BionteQ Bioscience Private Limited

Informatics Outsourcing

BioCOs Lifesciences

Accelrys Software Solution Pvt Ltd.

Bigtec

Bio Base Databases India Pvt Ltd.

CLC bio India Pvt Ltd (US based)

Genotypic Technology

LabNetworx

LabVantage Solutions Pvt. Ltd.

Mascon Life Sciences

Manvish Infotech

BrainWave Biosolutions Limited

Avestha Gengraine technologies Pvt Ltd

MIndFire Soultions Pvt Ltd

UVJ Technologies Pvt.Ltd

DiagnoSearch Life Sciences Pvt Ltd

Deloitte India Private Limited

Cognizant Technology Solutions

Annexures

106

Strand Life Sciences

Company Overview

Headquartered in Bangalore, Strand Life Sciences Private Limited (Strand), a premier company,

provides informatics products and customised software solutions. Founded in 2000, the company

has carved a successful path by capitalising on its technical proficiency in the lifesciences and

informatics domains. Strand has a successful track record in delivering IT solutions to top

pharmaceutical companies, biotechnology firms and reputed research institutes to address

bottlenecks in chemistry, drug discovery, system biology, healthcare and biotechnology.

Business Description

Strand has a highly developed business line, with products and services including software and

analysis tools for data mining, data warehousing, signalling pathway analysis, gene expression,

genome analysis, micro-array studies, biomarker studies, in silico drug design, pre-clinical

studies and predictive modelling. Besides, the company offers a range of software products in

information management and automation such as clinical data management, laboratory information

management and workflow automation.

Products and Services

avadis next-generation sequencing (avadis® ngs)

It is a valuable software tool for analysing, visualising and managing the data generated by next-

generation sequencing. It enables researchers to perform efficient analyses pertaining to gene

expression, detection of novel genes and transcription regulation data. In all, Avadis AGS is a one-

stop solution helping researcher’s carry out studies at a faster pace with increased efficiency and

reduced cost.

genespring®

This software tool is based on Avadis® platform and marketed by Agilent Technologies, USA. It is a

powerful analysis tool with a database of 1.5 million biological interactions, thus enabling analysis of

gene expression, genotyping and microarray studies.

Biolego

This tool has been developed on the Avadis® platform, which facilitates building and modifying

biological models to carry out studies related to system biology. The tool can handle large amount

of complex data and enables storage and retrieval. In addition, the tool allows detailed, real-

time visualisation and analysis of each model using data such as differential equations, kinetic

expressions and other parameters. BioLego has a built-in function that allows sharing of projects

and data among different users.

sarchitect

It is a one-stop platform for carrying out in silico docking and QSAR studies relevant to drug

discovery, thus assisting the process of lead optimisation and ADME prediction.

Virtual liver

Virtual Liver, the latest invention by Strand, is a predictive model that offers researchers a deep

insight on various biochemical pathways that maintain hepatic homeostasis. It is thought to replace

animal models for conducting clinical trials associated with drug metabolism and toxicity studies.

Strategic Initiatives


107

Strand is a constantly evolving firm with an excellent track record of many strategic partnerships

with leading pharmaceutical, biotechnology, bioinformatics and IT firms. The company has tied up

with Institut Curie, Paris, for developing image analysis platform; Narayana Hrudayalaya for building

tools for cancer translational research; and the most recent one with Trovagene, for validation and

commercialisation of Urine-Based HPV Test in India and South Asia.

Management Team

Chairman/CEO – Mr. Vijay Chandru

Director & Chief Technology Officer – Mr. Ramesh Hariharan

Chief Scientific Officer – Mr. Kas Subramanian

Annexures

108

Ocimum Biosolutions

Company Overview

Ocimum Biosolutions (Ocimum), established in 2000, is a Hyderabad-based company that

has pioneered informatics-based services in the US, Europe and India. The company provides

integrated genomics solutions with cutting-edge tools and databases enabling micro-array analysis,

laboratory information management, gene expression and next-generation sequencing analysis

through its Research-as-a-Service (RaaS) model. With a strong technical know-how, Ocimum has

positioned itself as a leading informatics service provider for many offshore customers from the

pharmaceutical, diagnostics, agricultural and food & nutrition domains.


Ocimum has a strong business portfolio with developed IT tools and services spanning various

domains including laboratory, sample and data management, bioresearch design and execution as

well as data analysis. The company has a strong foothold in contract research services for various

research organisations, biotechnology and pharmaceutical companies. It is well positioned to serve

the agricultural domain and is eyeing newer avenues across the energy, food and nutraceuticals

sectors.


laboratory information management system

Ocimum has designed various tools such as Biotracker™, Biotracker™ for Biobanking, Biotracker™

Lite, Biotracker™ Lite SaaS, Biotracker™ Biobanking SaaS and electronic lab notebook (ELN) to

cater to end users. These tools facilitate collection, storage, retrieval, distribution, comparison

and combining of data. Such systems can be incorporated by agricultural, pharmaceutical and

biotechnology companies; hospitals; and clinical trial centres to make the entire process effortless.

genesis enterprise system® software

This software helps in storage and assembly of data generated from clinical and genomic studies. It

helps in identifying the gene expression pattern across normal and diseased states; analysing and

comparing gene expression in various samples; discovering biomarkers; and identifying various

signalling pathways.

Bioresearch design and execution

Ocimum offers Good Laboratory Practices (GLP)-compliant services, which work on the Affymetrix,

Agilent, Illumina, ABI and Zeiss platforms. Services include sample isolation, DNA and RNA

extraction, gene expression, genotyping, sequencing and quantitative real-time polymerase chain

reaction (qRT PCR) and cloning.

Databases

Bioexpress® system

It is a gene expression database consisting of clinical, chemical, biological and pathological data on

more than 22,000 cell and blood samples from clinical and preclinical studies.

Toxexpress® system

This tool helps conduct drug toxicity and lead optimisation studies based on the effect of toxicity

on gene expression.


109

ascenta® system

This software enables identification of gene targets and potential biomarkers.

Toxshield™ suite

This tool facilitates prediction toxicology data depending on the genome information.

sciantis™ system

This is a gene expression analysis system providing details of micro-array gene expression profiles

of human, rat and mouse genes to understand the link between gene expression and pathological

condition.

Analytics Tools

Ocimum has developed a wide range of software and analysis tools for storage, managing and

visualising data for various genomic studies. These include Genowiz™ (Gene expression analysis),

Genchek™ (Sequence analysis), iRNAchek™ (analysis and design of siRNAs) and OptGene™ (Gene

optimisation).


Ocimum outsources bioinformatics services to the US and Europe. Over the years, the company

has made some strategic acquisitions to explore new avenues in lifesciences; the most recent of

these is the acquisition of Gene Logic’s Genomics segment in 2007. In 2010, Ocimum expanded

its services portfolio by incorporating bio-IT consulting. The company entered into many license

and distribution agreements in the past, with the latest partnership with Ocimed GmbH for the

distribution of Spoligotyping Kit (spacer oligonucleotide typing kit) in Europe. Moreover, Ocimum

successfully exploited the growing market opportunity for bio-IT in ASEAN countries to expand its

business in Malaysia through a joint venture with a local company. The new venture commenced

operations in April 2012 as Ocimum Biotech Asia sdn. bhd.

Management Team

CEO – Ms. Anu Acharya

President/CFO – Mr. Subash Lingareddy

Annexures

110

Molecular Connections

Company Overview

Molecular Connections Private Limited, headquartered in Bangalore, is a leading service provider of

computational discovery services, with competent technologies in drug discovery and information

technology. The mainstay business offering mainly includes cost-effective and time-saving solutions

for the drug development process. Molecular Connection has an impressive clientele including

pharmaceutical companies that avail its products to overcome obstacles in complex drug discovery

processes.


Molecular Connection has an excellent profile of specialised products and services spanning literature

informatics, cancer informatics, neuroinformatics, drug discovery informatics, cheminformatics and

biomarker and in silico services such as scientific text mining and database development. It actively

works on developing tools and software that enable storage, retrieval, visualisation of data from

micro-array and other studies. The company also provides intellectual property and publishing

services such as semantic tagging, ontology development and others.


netPro™

This is a comprehensive database of protein-protein and protein-small molecule interactions,

covering 20 species, and includes 320,000 such interactions. The database is available in various

modules and can be leveraged to conduct target identification, molecular pathway analysis, gene

expression prediction and drug profile study.

XTractor™

It is a knowledge database and an interface for retrieval and analysis of annotated biomedical

literature derived from millions of PubMed abstracts. The facts and relationships derived from this

literature are categorised into four segments with a current record of 13 million facts fed into the

system.

mcPairs

It is the first comprehensive knowledgebase of Indian patents (application and granted) with full-text

information including title, abstract, description, claims, legal status and file wrapper. It has an easy-

to-use search interface with advanced and simple search options.


Molecular Connection has inked several licensing agreements for its NetPro database, some of

which are with GlaxoSmithKline and research universities such as UCLA. Through collaboration

with research institutes and companies, Molecular Connection has developed several value-added

products to support lifesciences research. Few notable ones include the partnership with Plasma

Proteome Institute for developing the Plasma Protein Database and National Cancer Institute

for developing the Ureome Database. In 2011, the company also expanded its reach by offering

MCPaIRS service in Japan.

Management Team

Chairman – Mr. Limsoon Wong


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InterpretOmics

Company Overview

Bangalore-based InterpretOmics (previously Geschickten Biosciences), a bioinformatics contract

research company, analyses and interprets whole genome, transcriptome, exome, metagenome,

epigenome and proteome data. The company’s big data-driven technology platforms, such as

iOMICS and GoHealthyGo (India’s first enterprise-class genomics data analysis platforms), enable

bioinformaticians, computational scientists and clinicians to meaningfully address the full spectrum

of next-generation sequencing data challenges, which is key to improving human health at the

point of care.


InterpretOmics focuses on providing biological insights from complex multi-omics data for

understanding human disease, crop disease and drug response. The company specialises

in genome-scale data analysis and interpretation services and utilises public and proprietary

databases, advanced compute infrastructure and sophisticated algorithms to analyse data and

interpret results.


iomics

iOMICSTM is a cloud-based software platform for aggregating and structuring genomics and

biomedical data. Based on the semantic technology, iOMICSTM organises data from disparate

sources, such as DNA sequencers (Illumina, Roche, PacBio and Ion Torrent) as well as other critical

clinical information databases, for information mining and knowledge discovery.

goHealthygo

GoHealthyGo is a cloud-based health and wellness platform that connects healthcare seekers

to healthcare providers. This is India’s first comprehensive preventive and predictive healthcare

platform that integrates advanced genetic, medical, and behavioural knowledge for individuals,

physicians, enterprises, and institutions to deliver preventive healthcare.

Translational Bioinformatics services

The company develops techniques for integrating biological and clinical data that can assist in

significant biological decisions. The service is used by various biomedical scientists, clinicians and

patients.

Biomarker discovery

The company provides experimental design, sample processing, genomic technologies

and bioinformatic correlations to biomarkers for conducting clinical research, diagnostic and

pharmaceutical development, and clinical genome analysis.

cancer informatics

InterpretOmics provides analysis of molecular, genetic and clinical data pertaining to cancer risk,

prevention and treatment response. The company helps in identifying causal and passenger genes,

which is highly significant for the prognosis of sub-types of cancer. Thereafter, it applies advanced

statistical techniques such as parametric and non-parametric significance testing, k-means

clustering, hierarchical clustering and survival curves as well as data visualization techniques on

differential gene expression data to identify ’signature’ genes involved in causing a particular type

of cancer.

Annexures

112

Management Team

Founder and Chief Executive Officer – Mr. Prahalad H. Achutharao

Co-founder and Chief Scientific Officer – Dr. Asoke Talukder, PhD

Advisor – Prof. Nitai P. Bhattacharyya, PhD


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Jubilant Biosys

Company Overview

Founded in 2001, Jubilant Biosys Ltd is a wholly owned subsidiary of Jubilant Life Sciences (Jubilant),

an integrated pharmaceutical and lifesciences player. Headquartered in Bangalore, the company

enjoys global reach through the parent’s offices across Asia and North America. Jubilant Biosys

offers functional and integrated end-to-end solutions to large pharmaceutical and biotech entities

across the value chain of the drug discovery process.


Jubilant Biosys developed expertise in therapeutic areas of oncology, metabolic disorders, diseases

of the central nervous system as well as pain and inflammation. The company possesses in-depth

knowledge in discovery informatics, computational and medicinal chemistry, structural biology, in

vivo, in vitro models and translational sciences. Jubilant Biosys enjoys strong support in the form of

clinical development and manufacturing capabilities from other subsidiaries.


discovery informatics

Services are aimed at resolving the challenges arising during each stage of the drug discovery

process. These include custom curation, genome data analysis, target intelligence and analytics,

clinical trial intelligence, commercial products, and pharma IT services.

computational chemistry

These services assist in the process of drug design with the company’s medicinal chemistry, biology,

and drug metabolism and pharmacokinetics (DMPK) teams. These include molecular modelling

studies such as pharmacophore and quantitative structure–activity relationship (QSAR) modelling,

protein structure-/ligand-/fragment-based drug design, homology modelling, docking and scoring,

chemoinformatic analysis, and de novo design.

structural Biology

These services cover cloning, expression, protein purification, crystallisation, crystal image

annotation, X-ray diffraction data collection, structure solution and refinement.

in Vitro Biology

It includes services to conduct a variety of biochemical and cellular assays against enzymes, G

protein-coupled receptors (GPCRs), ion channels (e-phys), nuclear hormone receptors (NHRs) and

transporters.

in Vivo Biology

It comprises services to conduct PK-PD and efficacy studies in a variety of disease models connected

to oncology, metabolic disorders, pain, inflammation, and therapeutic areas for respiratory diseases.

Databases

Pathart (Pathway database)

PathArt includes manually curated biomolecular interactions with major focus on signalling and

metabolic pathways in disease conditions. The database covers more than 3000 high-priority

pathways.

Annexures

114

molsign (Biomarker database)

Molsign is a manually curated disease-centric Biomarker database. It comprises information on

nearly 9000 biomarkers spanning cancer, arthritis and diabetes.

chembiobase (small molecule database)

Chembiobase includes a complete set of target-centric ligand databases of small molecules with

specific activity against targets and target families. The database covers more than two million

molecules with their properties.


Jubilant has been constantly collaborating with leading pharmaceutical and biotech companies,

academic institutions, and research foundations worldwide. Most recently, the company partnered

with Mnemosyne Pharmaceutical for drug discovery, with focus on developing subunit-selective

NMDA receptor modulators (SNRMs) in the field of neuropsychiatric diseases such as Alzheimer’s

and schizophrenia. In addition, Jubilant partnered with Europe-based Norgine for drug discovery in

the gastrointestinal therapeutic area.

Management Team

Chairman and Managing Director (Jubilant Life Sciences) – Mr. Shyam S. Bhartia

Co-chairman and Managing Director (Jubilant Life Sciences) – Mr. Hari S. Bhartia

President (Jubilant Biosys and Chemsys Limited) – Dr. Subir Basak


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Genotypic Technology

Company Overview

Founded in 1998, Genotypic Technology (Genotypic) is the first genomics service provider in India.

Headquartered in Bangalore, the company offers data analysis and interpretation services for

genomics and bioinformatics. It also caters to educational institutions. Genotypic is the first company

to receive the Agilent Technologies Service Provider certification for three leading microarray

applications globally and the first in India to be certified for Ion Torrent PGM. The company, having

an ISO 9001:2008 accreditation and an 11,000 square feet genomics facility in Bangalore, is India’s

first genomics company to operate on SAP. Research conducted at Genotypic is recognized and

quoted in more than 150 publications.


Genotypic offers techniques such as microarray analysis, next generation sequencing (NGS)

and other bioinformatics services and solutions to both domestic and international companies

operating in the pharma and biotech sector. The company has successfully executed more than

500 NGS projects and over 2,000 Microarray projects for both Indian and global clients. Genotypic

is acknowledged by India’s Department of Scientific and Industrial Research (DSIR) and has been

awarded several grants by domestic and foreign funding organizations.

Products

genotypic catalog microarray

Genotypic provides direct use Microarray for profiling gene expression, ChIP-on-chip, aCGH,

Methylation, SNP discovery, In-Dels and DNA Capture for a variety of eukaryotes, prokaryotes,

fungi and all model organisms. It is the first company in the world to build Microarrays for Banana,

Tobacco, Eucalyptus, Tea, Tomato, Guinea pig and Rabbit.

Biointerpreter

This is a trouble-free, easy-to-use, web-based biological interpretation tool for analysing Microarray

data. The tool significantly reduces analysis time to hours from weeks.

medruner

This interactive tool supports identification, analysis and reporting of biologically important and

purposeful information from the Pubmed abstracts in few minutes. The tool has been tested to

handle around 10,000 abstracts.

Pubmine

PubMine is a tool that enables searching abstracts and generating reports on gene-term association

with citation evidences in a short time. The tool was developed to mine large set of Medline gene

abstracts and keywords of interest.

seq Qc

This is a simple desktop application for quick Quality Control and reporting of NGS and processed

sequence data.

Bio-iT @ genotypic Technology

This technology aims at studying current methodologies and develops newer techniques to

manage, analyze and obtain provable hypothesis from biological data. The company also tackles

Annexures

116

varied biological issues and offers improved solutions for discovering and defining unexplored

biologically significant events.


Strategic projects undertaken by the company include:

Human Healthcare

• Building targeted re-sequencing panel of markers for chief diseases in India

• Developing sequencing-based assays for affordable and targeted clinical trials

• Designing genomics-based assays to help in the discovery of novel and more effective drugs

Plant genomics / agrigenomics

• NGS/ Microarray-based analysis of medicinal and commercially-important plants

• Identification of SNPs and developing genotyping markers

Genotypic is focused on building strategic alliances with domestic and global companies to boost

research activities in the bioinformatics space. In line with this, Genotypic partnered with companies

from South Africa, Singapore, Malaysia, Thailand and Israel.

In addition, as a part of its industry-academia knowledge exchange and research program, the

company entered into an agreement with Vellore Institute of Technology on scientific research and

academic collaboration in 2013.

Management Team

President, Founder and CEO – Dr Mugasimangalam C Raja

Co Founder and Executive Director – Dr Sudha Narayana Rao


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Novo Informatics

Company Overview

Based in New Delhi, Novo Informatics is a life sciences-based R&D company. Novo provides

customised technology to the lifesciences industry, research, academics, and hospitals to simplify

the drug discovery process. The company seeks to develop bio-medical software to assist in

combating widespread diseases. Novo offers a drug discovery model that can lower the cost and

time associated with delivering drugs to the market.


Novo leverages on the long-standing SCFBio tradition of producing state-of-the-art technologies

for research communities and pharmaceutical companies to streamline the entire process from

genome to drug. The company focuses on target modelling and lead molecule designing for

diseases. Novo’s service portfolio encompasses target modelling, v-ht molecule screening, hits

molecules identification, hit-to-lead optimisation, and molecule synthesis that can be effectively

integrated into pharmaceutical research objectives and operations.


Proteonov

Proteonov is a comprehensive protein structure annotation package. It mainly comprises 3D

structure generation from the stretch of amino acid sequence. In addition, Proteonov simplifies

structure analysis by using a variety of physicochemical properties. The structure refinement

algorithm is inbuilt to enhance the reliability of the package.

drugonov

This is a comprehensive package for accelerating the drug discovery process. It builds a complete

set of modules from target selection to hit identification of the molecule. This technology works

on efficient algorithms and scientific modules for rapid screening of a library of million compounds

against the active site of target.

strategic initiatives

The company collaborated with Supercomputing Facility for Bioinformatics & Computational

Biology (SCFBio), IIT Delhi to develop new technologies for structure modelling and analysis of

human proteins, and with MBiotech, UK, to develop and validate novel molecules.

Management Team

Director, Co-founder and Head of Global Business Operations – Mr. Sahil Kapoor

Director, Co-founder and Faculty Facilitator – Prof. B Jayaram

Director, Co-founder and Head of R&D Operations – Mr. Avinash Mishra

Annexures

118

Wipro

Company Overview

Wipro Limited, headquartered in Bangalore and established in 1945, is India’s second largest IT

company providing consulting and outsourcing services. Wipro is a global leader with diversified

business lines, delivering products and services ranging from consumer care to information

technology. Through its unmatched expertise in IT, it broadened its services to the healthcare

domain in 2000 and to the pharmaceutical and lifesciences domains in 2002. The company

launched about 1,100 programmes in the pharmaceutical and lifesciences domains with the help

of a powerful scientific intelligence team of technical consultants, physicians, IT professionals and

validation specialists.


Wipro has an established and diversified business line spanning various verticals including

aerospace, automotive, banking, communication service providers, consumer goods, energy,

government, healthcare, high-tech, insurance, manufacturing, media, medical devices, mobile

devices, natural resources, pharmaceutical and lifesciences, professional services, public

infrastructure, retail, securities and capital markets, telecom equipment, transportation and utilities.

The company caters to healthcare, pharmaceutical and lifesciences clients at various levels, with

services ranging from infrastructure management to analytics and information management.


Healthcare industry

Health level 7 (Hl7)

It is a customised tool aiding the integration of diverse clinical and administrative information and

enabling its exchange among pharmacy, clinics, hospitals, patients and physicians across different

locations.

Hospital information system (His)

Wipro’s HIS is a custom-made solution based on Microsoft.NET platform for large, medium-sized

hospitals and clinics. The tool consists of 40 modules, and its incorporation enables integration

among various departments within hospitals. In addition, it encompasses various features such as

alerts and notification that are signalled to nurses and doctors, enabling them to monitor critical

clinical parameters.

clinical information system (cis)

This system draws parallelism from the HIS module, but integrates information type in a different

manner from HIS. The CIS module assembles outpatient and inpatient details, registration, discharge

summary, security and identity details, among others.

e-Health

Various software tools in the E-Health domain include E-Health networks, Remote Health Monitoring,

TeleHealth and M-Health as well as knowledge portals for patients.

medical record retrieval Tool™

This tool provides an integrated electronic solution to help doctors, patients and insurance

companies in retrieving past medical records at a faster pace.


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Pharmaceuticals and Lifesciences

wipro rapid Trials (clinical saas platform)

It provides an integrated platform to carry out high-end services including clinical data management,

clinical trials management, and safety and security data management with an inbuilt feature to store,

retrieve and analyse the same.

clinical collaboration Portal

This tool aids in networking, communicating and managing data among trial conductors,

participants, FDA and sponsors. In addition, the tool has combined features of safety management

and knowledge sharing to ease the clinical trial procedures and enable better compliance with

drug safety.

optimised manufacturing

IT models such as Laboratory Information Management Systems (LIMS), Process Analytical

Technology (PAT), Corrective and Preventive Action (CAPA) and others help optimise and validate

the manufacturing process in the pharmaceutical and biotech industries.

Management Team

Chairman– Mr. Azim Premji

CEO, IT Business & Executive Director – Mr. T. K. Kurien

Executive Director & Chief Finance Officer – Mr. Suresh Senapaty

Annexures

120

TCS

Company Overview

Tata Consultancy Services, founded in 1968 and headquartered in Mumbai, has established

a global footprint in IT, business and outsourcing services. TCS offers competent products and

services through a Global Network Delivery Model™ (GNDM™), which is the yardstick for software

development. The company has expanded its business verticals by exploring newer avenues

across the lifesciences and healthcare domains. In 2005, TCS became India’s first IT company to

offer bioinformatics services by capitalising on its sound IT infrastructure and technical intelligence.


TCS offers promising solutions across various industries such as banking, financial services

and insurance, retail and consumer-packaged goods, telecom, media and information services,

high-tech, manufacturing, lifesciences and healthcare, energy, resources and utilities, and travel,

transportation and hospitality. In the healthcare segment, it offers infrastructure, data management

and sharing, and analytics services to enhance operational efficiency of the organisation. In the

lifesciences domain, the company delivers services such as bioinformatics, clinical trial management

systems, drug safety systems, LIMS and ELN.


med mantra

It is an integrated tool for an efficient hospital management system. Med Mantra is developed across

four modules: Business (Administration, EMR, Pharmacy, etc.), Architecture (Workflow, Security, etc.),

Internal and External Systems (Insurance companies, lab, etc.) and Third-Party Solutions (Biometrics,

Drug Databases, PACS, etc.).

clin-e2e

This is a cost-effective and time-saving tool for all of the four phases of clinical trials. It is an

integrative solution enabling convergence and communication of data among sponsors, regulatory

bodies, participants and trial conductors. The tool enables pharmaceutical companies to monitor

the progress of clinical trials in line with the regulatory framework.

silicone ambulatory ecg device and solution

This device facilitates quick monitoring of heart conditions and simultaneous transfer of data to

physicians by using radiofrequency. It enables doctors to rapidly decide the mode of treatment, and

thus prevent heart failures and heart attacks.

Bioinformatics solution

It covers high-end solutions for four major domains: Genomics, Proteomics, Simulation, and Drug

Design; it assists in storage and distribution of related data and its efficient analysis.


TCS has diversified its offerings by collaborating with niche players to develop solutions addressing

their concerns. In lifesciences, the company partnered with University of California, Berkeley, to

explore new prospects of pharmacogenomics and next-generation sequencing. The collaborative

projects undertaken include Genome Commons Navigator, Exome Sequencing, Comparative

Assessment of Genomic Interpretation (CAGI) and Annotating Metagenomic Samples.

The company has undertaken strategic acquisitions to strengthen and upgrade the products


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and services portfolio. The acquisition of Computational Research Laboratories (CRL) in August

2012 would enable TCS to deliver integrated high-performance computing solutions for storing,

managing and visualising data in large sizes. The company is now strategically shifting its focus to a

non-linear growth model and pursuing developments in software products (TCS financial solutions),

platform-based BPO and iON (IT-as-a-service solution for small and medium businesses).

Management Team

Chairman – Mr. Cyrus Mistry

Vice Chairman – Mr. S. Ramadorai

CEO/Managing Director – Mr. N. Chandrasekaran

Annexures

122

Mahindra Satyam

Company Overview

Headquartered in Hyderabad, Mahindra Satyam (formerly Satyam Computer Services) is an

IT services company. Mahindra Satyam is a subsidiary of Mahindra Group, a global industrial

conglomerate. The company was formed subsequent to the takeover by Mahindra Group’s IT arm,

Tech Mahindra, on 13 April 2009. Mahindra Satyam offers consulting and information technology

(IT) services spanning various sectors such as financial services, automotive products, trade,

retail and logistics, information technology, and infrastructure development. Mahindra Satyam has

development and delivery centres across the US, Canada, Brazil, the UK, Hungary, Egypt, the UAE,

India, China, Malaysia, Singapore and Australia.


Mahindra Satyam is among the top 10 leading business and information technology services

companies in the world, listed on the Pink Sheets, National Stock Exchange (India) and Bombay

Stock Exchange (India). The company’s Global Healthcare practice offers innovative, end-to-end

integrated IT solutions for healthcare providers to enhance operational efficiency. The Life Sciences

practice provides a wide range of innovative solutions for effectively managing the drug discovery

and development processes. Mahindra Satyam specialises in offering enterprise solutions, supply

chain management, client relationship management, business intelligence, business process

quality, engineering and product lifecycle management, and infrastructure services.

Services

Mahindra Satyam offers comprehensive IT services such as hospital information systems and

electronic medical record management, healthcare analytics, human capital management, business

process management, revenue cycle analytics, enterprise resource planning, and emergency

management solutions.

Under the Life Sciences division, the company offers IT services such as discovery informatics,

pre-clinical solutions (data integration, analysis and reporting services to Life Sciences customers),

clinical trial, data, and supplies management, clinical safety solutions, and drug portfolio

management. Mahindra Satyam also provides BPO services including statistical analysis, clinical

data management, safety narrative writing, product support and content management.


In 2009, Mahindra Satyam renewed its contract with GlaxoSmithKline (GSK), one of the leading

research-based pharmaceutical and healthcare players in the world, for five years. The latter

provides high-end artwork and design services to pharmaceutical companies. Mahindra Satyam

has been serving GSK since 2002.

Management Team

Chairman – Mr. Vineet Nayyar

Chief Executive Officer– Mr. C P Gurnani

Chief Financial Officer – Mr. Vasant Krishnan


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Infosys

Company Overview

Founded in 1981, Infosys is a global leader in consulting, technology and outsourcing with USD7.4

billion in revenues in FY13. The company provides business consulting, technology, engineering

and outsourcing services to help clients in over 30 countries. Infosys pioneered the Global Delivery

Model (GDM), based on the principle of making the best economic sense with the least amount of

acceptable risk. The company has a global footprint with 69 offices and 87 development centres

across the US, India, China, Australia, Japan, the Middle East, the UK, Germany, France, Switzerland,

the Netherlands, Poland, Canada and others.


Infosys offers an array of services to pharmaceutical and lifesciences companies, leveraging

Oracle’s Health Sciences Global Business Unit (HSGBU) suite of applications. The company

provides end-to-end solutions to meet clinical research and data management requirements. The

services encompass assistance from protocol design to regulatory submissions including data

management related activities.

Services

The company offers requirement-based installation, implementation, customisation and upgrade

support for the following applications:

Applications in Clinical Data Management Systems (CDMS): Oracle ClinTrial, Oracle Clinical and

Oracle LabPas

Applications for Electronic Data Capture (EDC): Oracle Clinical-Remote Data Capture (RDC) and

Oracle-Inform

Applications for Safety Data Management: Oracle Argus and Oracle Adverse Event Reporting

System (AERS)

Applications for Data Warehousing and Analysis: Oracle’s Life Sciences Data Hub (LSH), Oracle

Clinical Data Analytics (CDA) and Oracle-Clinical Development Centre (CDC)

Seibel Clinical Trial Management System (CTMS): Maintenance of site and personnel information,

generation of Clinical Research Associate (CRA) visit reports, and issues management

Management Team

Co-founder, Executive Co-chairman – S. Gopalakrishnan

Co-Founder, Chief Executive Officer and Managing Director – S. D. Shibulal

Senior Vice-President – Srikantan Moorthy

Annexures

124

Institute of Bioinformatics

Company Overview

Established in May 2002, Institute of Bioinformatics (IOB) is a not-for-profit organisation engaged in

bioinformatics research. Headquartered in Bangalore, the institute promotes research on the study

of human and other genomes by emphasising on advanced research in databases, computational

genomics, proteomics and comparative genomics. IOB uses computational and experimental

approaches to catalogue genes as well as proteins encoded by the human genome. It aims to

provide a Human Protein Reference Database (HPRD) free of cost using open-source technologies

and experimentally verify predicted human genes using molecular biology and proteomics-based

methods.


IOB has well-equipped bioinformatics and experimental facilities to conduct research in molecular

biology, cell culture, bioinformatics, genomics and proteomics. Studies are conducted on gene

expression profiles, genome copy number variations, microRNAs, and alternative splicing of genes to

understand signalling pathways in various cancers. Specifically, quantitative proteomics approaches

are used for the identification of biomarkers in human diseases and infectious microorganisms; the

objective is to understand biological systems and human diseases. IOB has created highly curated

protein databases, such as HPRD and Plasma Proteome Database, and several resources for gene

expression data pertaining to cancers and primary immunodeficiency diseases.

Databases

netPath and netslim

NetPath is an extensive database of signal transduction pathways in humans and currently contains

all of the information pertaining to 10 cancer and 10 immune signalling pathways. NetSlim represents

a subset of reactions depicted in NetPath; it was developed by applying a set of stringent criteria to

generate high-confidence signalling maps as well as to enable easy visualisation and interpretation

of the pathways.

Human Protein reference database

This database represents a centralised platform to visually depict and integrate information related

to protein-protein interactions, post-translational modifications, tissue expression, expression in cell

lines, sub-cellular localisations, and enzyme-substrate relationships and disease associations for

each protein in the human proteome.

Human Proteinpedia

This is a community portal for sharing and integrating human protein data. The resource allows

global research labs to contribute and maintain protein annotations derived from various platforms

such as mass spectrometry, immunochemistry and fluorescence-based experiments.

Plasma Proteome database

This is an exhaustive collection of all human plasma proteins along with their isoform information,

particularly expression, disease localisation, post-translational modifications and single nucleotide

polymorphisms.

resource of asian Primary immunodeficiency diseases (raPid)

RAPID is a web-based compendium of molecular alterations in primary immunodeficiency diseases.

It contains detailed information about affected genes and proteins as well as protein-protein


125

interactions, microarray gene expression profiles, and associated deleterious and novel mutations.

TBnet

This portal was developed with a special focus on contribution by Indian researchers on various

issues related to tuberculosis. The clinical, epidemiological and molecular manifestation of this

disease and the development of multiple drug resistances in recent times pose a major health

concern in third world countries such as India.

india cancer research database

This database provides details of scientists and physicians involved in cancer research in India

along with the information regarding their areas of expertise, research publications and funded

grants. The main goal of the database is to foster collaborations among researchers and to provide

a snapshot of ongoing research initiatives and activities in India.

Strategic initiatives

IOB has undertaken various initiatives to collaborate with research institutes and companies and

thereby add value to its research database. Some notable collaborations are with RIKEN Centre

for Allergy and Immunology (RCAI) in Yokohama to study immune signalling pathways for primary

immunodeficiency diseases; Kidwai Memorial Institute of Oncology (KMIO), Bangalore, to study

genomics of gastrointestinal cancers; and National Institute of Mental Health and Neuro Sciences

(NIMHANS) to identify biomarkers for early detection of meningitis, stroke, and molecular profiling of

temporal lobe epilepsy. IOB has also partnered with various institutes for genomics and proteomics

projects, exchange of scientists, developing a plasma protein database, creating user interface

design, and educational and graphic visualisation tools.

Research Team

Dr. Ravi Sirdeshmukh

Dr. B. L. Somani

Dr. Aditi Chatterjee

Annexures

126

Company name Website

Strand Life Sciences Pvt. Ltd. www.strandls.com

Ocimum Biosolutions (India) Ltd www.ocimumbio.com

Molecular Connections P Ltd www.molecularconnections.com

InterpretOmics http://www.interpretomics.co

Jubilant Biosys Ltd www.jubilantbiosys.com

Novo Informatics http://www.novoinformatics.com

Wipro http://www.wipro.com

TCS http://www.tcs.com/Pages/default.aspx

Mahindra Satyam http://www.techmahindra.com/en-US/wwd/industries/Pages/HLS/Life_Sciences/default.aspx

Infosys http://www.infosys.com/pages/index.aspx

Institute of Bioinformatics http://www.ibioinformatics.org/about_us.php

Eminent Biosciences www.eminentbio.com

GVK Biosciences Private Limited www.gvkbio.com

BioAxis DNA Research Centre www.dnares.in

Xinnovem www.xinnovem.in

BionteQ Bioscience Private Limited www.bionteq.com

Informatics Outsourcing www.informaticsoutsourcing.com

BioCOs Lifesciences www.biocosls.com

Accelrys Software Solution Pvt Ltd. www.accelrys.com

Bigtec www.bigteclabs.com

Bio Base Databases India Pvt Ltd. www.biobase-international.com

CLC bio India Pvt Ltd (US based) www.clcbio.com

Genotypic Technology www.genotypic.co.in

LabNetworx www.labnetworx.com

LabVantage Solutions Pvt. Ltd. www.labvantage.com

Mascon Life Sciences www.mgl.com/Healthcare/lifesciencesoverview.htm

Manvish Infotech www.manvish.com

BrainWave Biosolutions Limited www.brainwave.in

Avesthagen Limited www.avesthagen.com

MIndFire Soultions Pvt Ltd www.mindfiresolutions.com

UVJ Technologies Pvt.Ltd www.uvjtech.com

DiagnoSearch Life Sciences Pvt Ltd www.diagnosearch.com

Deloitte India Private Limited www.deloitte.com/in

Cognizant Technology Solutions www.cognizant.com


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Department of Biotechnology

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