India-U.S Health Cooperation

Washington, DC
September 25, 2008

India and the US over the years have established a strong collaboration in the area of public health which extends to a wide range of issues - HIV, TB, Malaria, Polio, Maternal and Child health, Tobacco control, Environmental and occupational health, Vaccine development, Avian influenza and emerging and re-emerging infectious diseases. By working together, the two sides are: 1) developing new scientific knowledge; 2) creating new technology for the development of vaccines, drugs, diagnostic tools, and devices; and 3) working together to control, prevent, and eliminate diseases. The benefits from these collaborations flow back to both the American and Indian people, and through the good will generated on both sides, to Indo-American relations in general.

US Health Secretary visited India in Jan 2007 and reviewed bilateral health cooperation and exchanged ideas on developing science-based systems and standards to govern two-way trade. 

The US Government through its Agency for International Development (USAID) and the U.S. Department of Health and Human Services (HHS) are working in partnership with the Government of India, through the Ministry of Health and Family Welfare and its nodal agency, the Indian Council of Medical Research (ICMR), academia and the industry, to support collaborations and programs that are designed to: 

· Increase the capacity of Indian institutions and develop
infrastructure;
· Provide training in biomedical research, biotechnology, and public 
health;
· Increase access to, the quality of, and demand for family health care; 
· Nourish needy mothers and children;
· Control, prevent, and eliminate infections diseases;
· Develop and share scientific knowledge; 
· Develop and evaluate new vaccines, drugs, diagnostic tools, and devices; 
· Strengthen quality assurance;
· Support improved policies and planning for maternal and child health, reproductive health, HIV/AIDS, and other infectious diseases;
· Help develop central and state policies for population, health and nutrition, and specific interventions, such as immunization; 
· Promote stronger and sustainable private-public sector partnerships ; and
· Improve evidence based decision making

Bilateral Agreements, Training and Capacity Building: The Indian Ministry of Health and Family Welfare and the US Department of Human and Health Services have signed 5 Joint Statements covering the areas of HIV/AIDS (16 projects), Maternal and Child and Human Development and Research (19 Projects), Environment and Occupational Health (6 projects), Emerging and Re-emerging Infectious Diseases and the International Centre of Excellence in Bio-medical Research. The Indo-US collaboration has successfully taken place for the last 30 years or so and has led to mutual benefits in terms of infrastructure strengthening, transfer of technology and several scientific publications. 

Collaboration between National Institute for Pharmaceutical Education and Research (NIPER) and US Universities: India is in the process of setting up six new National Institute for Pharmaceutical Education and Research. The Department of Pharmaceutical seeks the support of the US Government to establish human resource collaboration between US Universities/ National Institutes of Health and NIPER.

International Partnership on Avian and Pandemic Influenza 2007: To strengthen international efforts to combat Avian and Pandemic Influenza and express the commitment of the Government of India in dealing with global health security, India successfully hosted the International Partnership on Avian and Pandemic Influenza in December, 2007. Representatives of 111 countries and 29 international organizations participated. A Road Map that sets out the actions that a nation could implement for the establishment of achievable benchmarks by concerned government entities and other stakeholders was presented by India. 

Collaboration between Regulatory authorities: As a follow up to the visit of Secretary Health, a delegation from US FDA visited India in April 2008 with the objective of establishing a bilateral cooperation programme with the Health Ministry. A delegation from the Health Ministry visited Washington in June 2008 and met with US FDA officials. India is in the process of strengthening its Drug Regulatory Framework, including through legislative amendment. The setting up of the Central Drug Authority in India will further strengthen the regulatory framework to the mutual advantage of both Indian and U.S. Pharmaceutical industries. The two Governments have been collaborating in the area of training on the regulation of medical devices, clinical research, pharmacovigilance, and e-governance. Indian health experts have received training at the US FDA. The US FDA plans to open offices in India in consultation with the Indian Authorities.

HIV/AIDS: India became a part of the US President’ Emergency Plan for AIDS relief (PEPFAR ) initiative in May, 2005. India has been receiving funds worth US$ 30 million annually from the US Office of Global AIDS Coordinator (OGAC), USAID and Center for disease Control and Prevention (CDC), USA. The program focuses on four priority states: Tamil Nadu, Maharashtra, Andhra Pradesh, and Karnataka. 

Influenza: HHS/CDC, the U.S. Department of Agriculture (USDA), and USAID collaborate with the Ministry of Health and Family Welfare and the Ministry of Agriculture institutions on pandemic preparedness, physician training, disease burden estimations, and training for laboratory detection of human and avian influenza. Several Indian professionals have received training at HHS/CDC. India has contributed to the global efforts toward ever greater preparedness for Avian and Pandemic Influenza by maintaining total transparency about outbreaks that have taken place so far, by taking immediate action to contain the outbreaks and by offering a unique tool for assessing national and international preparedness in the form of the road map developed at the New Delhi International Ministerial Conference on Avian and Pandemic preparedness in December, 2007. India believes it is important to expand global capacity for manufacturing influenza vaccine and is willing to collaborate in this regard.

Family Health, Maternal and Child Survival and Reproductive Health: Through policy, advocacy and training, engaging the private sector, and demonstrating effective public private partnership (PPP) models, USAID is helping to improve nutrition and health through immunization and expanded access to family planning methods in three north Indian states. USAID partnered with the Government of India to improve evidence based decision making through efforts such as the National Family Health Survey. HHS/NIH is conducting collaborative biomedical research with the Ministry of Health & Family Welfare/Indian Council of Medical Research institutions, academic institutions, and hospitals on maternal, child, and reproductive health. Indian scientists are also working on these subjects in laboratories based in the US. 

Polio: External assistance is being received from Donor Partners to eradicate Polio. CDC, USA has assisted India in the procurement of Oral Polio Vaccines upto the year 2006-07. 

Tuberculosis: USAID and HHS/CDC collaborate with the Ministry of Health and Family welfare for improved implementation of the Directly Observed Treatment Short-course (DOTS) strategy to control tuberculosis (TB). The two sides are working to address emerging challenges related to TB-HIV co-infection and multi-drug resistant TB and provide technical assistance for infection control practices and improved public-private partnerships in TB control. The US National Institutes of Health is providing technical and financial support for an International Centre for Excellence in TB research in Chennai. 

Vaccine Development: HHS/CDC and NIH are working with the Ministry of Science and Technology to develop vaccines against malaria and rotavirus. The technology for the rotavirus vaccine was transferred from the U.S. to Bharat Biotech International Limited, Hyderabad and is ready for phase III testing in India. The Indo-U.S. Vaccine Action Program (VAP), a 20-year-old bilateral collaboration supporting research on vaccines, immunology and related biomedical issues, was renewed in 2007. 

Brain Research Program: India’s National Brain Research Institute and NIH are involved in this program. The project promotes neuroscience and mental health research through targeted workshops to stimulate new joint research proposals.

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