 India innovation, for many of you who have been tracking us, we have been tracking the great progress that India has been making in terms of ramping up its strength in innovation. We all know that India is an amazing country in terms of its ability to supply and make generics. Actually over the past decade, if we just look at ANDA or generic filings with the FDA, India accounts for over 35% of those filings and recently has overtaken the United States as the number one country in the world on generics, but that's not what we're here to talk about. We're here to talk about innovation, of which there are some promising science and challenges. Challenges include the relatively low per capita R&D spend in India. It's 20% of that in countries like Germany and Japan and slightly more relative to China. But there are some very encouraging signs and one of the encouraging signs that I'll point out is the number of Indian students that are actually studying abroad. Just last year, 750,000 Indian students studied abroad, 28% of which were in the United States. It was actually the second leading country for international students across the world. So with that said, we'll very much look forward to the panel. I have the great privilege to introduce Sanat Chapa Dapa Day and I think I've gotten your name correct. Yes, Sanat. I practiced it intensively over the weekend. Sanat is the head of one of the greatest most iconic manufacturing divisions across all of industry at Merck. And before I hand it over to you, Sanat, I'm just struck by a line that was espoused by Pfizer and Albert Borla over the last year. And it was a line from the great founder of Merck, George Merck, who said that if you make great medicines, the profits will follow. So now I'll hand it over to you for India Innovation. Thank you, Andy. Thank you very much. Good morning. Good afternoon and good evening to all of you all. Welcome to the session on India Innovation Panel. As you have seen, we have a very distinguished group of panelists whose bio have already been posted in the website, their Amitabh Khan, Chief Executive Officer of the National Institution for Transforming India, Dilip Sanghvi, Managing Director, Sun Farmer Critical Industries Limited, Hari Bhartiya, is of course not being able to join today, Professor Vijay Raghavan, Principal Scientific Advisor of Government of India and Dr. Nareesh Trehan, Chairman, Medanta Hospital. As you heard from Andy, we all know that necessity is always the mother of invention. And we have seen the world coming together on a war footing to respond to the COVID-19 pandemic. We are witnessing scientists and medical technology developers leveraging innovations to launch a scientifically rigorous response to the novel coronavirus. And with the COVID-19 pandemic causing massive disruptions in our health care system, many Indian innovators are rising to the challenge. It's well known that India is one of the largest producers of vaccines in the world. But now what we see is COVID is resulting in innovative vaccines being discovered and produced indigenously in India. And the best example of that is Covaxin. That's simply fantastic. COVID-19 crisis has also created new partnerships, for example, between serum and, you know, first AstraZeneca, then Novavax. And we have now the collaboration between J&J and BioE and there are some more. So in other words, COVID-19 has brought an unprecedented sense of urgency to the evolution of scientific innovations and technical cooperations. On the conception of an early idea or a prototype to mass production and on-ground deployment of the innovation. And the need of the hour is for the government, industry and academia to leverage this new found innovation of efforts for a sustained ecosystem of innovation in India. We are witnessing the immediacy of the present situation enabling that innovation at all levels be it increased funding from the public and the private sector or faster regulatory approvals. And therefore, I would dare say that will be prudent for governing bodies to start laying the guidelines that should allow all these new found changes in the innovation ecosystem to persist even beyond the pandemic. So let me start with Amitabh Khan and Vijay Raghavan. Amitabh and Vijay, during the pandemic, we have witnessed very strong partnerships between the government, the healthcare, tech entrepreneurs, patient groups with the farm industry. And that includes ensuring supplies of essential medicines, digital mapping of resources, setting up dedicated hospitals. We also know that the future respiratory pandemics may have new features that may take longer to identify and they may be vaccine recalcitrant. So it may be important to consider how we can have very strong yet operationally viable non-pharmacological interventions like high quality masks with HEPA filters that can be speedily and inexpensively deployed widely can be used to allow healthcare and frontline workers to function at full capacity. So given all of these things, may I request both of you to comment on the measures that are being put in place to combat a potential wave three of the pandemic. And if you can also touch upon the post-COVID opportunities for India in RND and manufacturing. And to that extent has COVID pushed India to seriously focus on biopharma innovation and RND. Amitabh, can I request you to go first, please? Yeah, when COVID struck India, you know, we were not manufacturing PPEs, we were not manufacturing ventilators, but with support of private partners, India's developed the technical capability to manufacture ventilators, oxygen concentrators, PPEs, sanitizers, surveillance mechanism has been strengthened to capture and monitor disease outbreaks in different regions. Indian SARS-CoV-2 genome sequencing consortia in Saqqog has been set up by the government for large-scale sequencing of viral genome to identify variants of concern. Vaccination production capacities have been enhanced and oxygen transport facilities have been established. We've set up a vast number of PSA oxygen generation plants in hospitals, 551 of them to be exact across the country, mobile ICU bedded facilities with well-equipped medical devices and sanitation protocols are now being set up by different states in rural and remote regions. And vaccination for 18 years and above is being driven on a war footing. Just yesterday, we've done close to about, you know, at the 8.2 million vaccinations at the, you know, which has been a record of sorts. And with this momentum, we'll be able to vaccinate majority of the people in coming months. Civil society organizations are all supporting government in combating the pandemic. We have more than about 113,000 civil society organizations that are partnering the government. And, you know, all this has been possible because we worked in collaborative partnership with the civil society, the private sector, everyone together. You asked about R&D initiatives and our view is that right now, Indian pharmaceutical industry is currently valued at about 42 billion US dollars. And we are, our aim is that we should make it a $200 billion segment by 2030 and innovation is required in biopharma segments. We feel that there are moonshot areas such as biosimilars, often drugs, complex generics, vaccines, depression, medicine and antivirals, which have the potential for innovative drug discovery and development. We are looking at ways to incentivize research in biopharma and help India transition from a generic player, a high volume generic player to a high value, high volume player in the global pharma market. And research incentivization will enhance innovation in the country, boost exports and create high-skill employment. And we are also supporting all leading international companies and scientific communities, which have the required technical skills to collaborate with India for R&D in several moonshot areas. We are partnering private sector in R&D and currently, you know, research consortiums have been successful in finding candidates for COVID-19 vaccine and similar strategies will be taken up to drive innovation in drug discovery and development of medical technologies. To further strengthen the research ecosystem, industry and academy are collaborating and we are incentivizing research as well. But my belief is that Indian pharmaceutical sector is private sector driven, the government acts as a facilitator and catalyst and we'll do everything possible to make this a top class sector, the key sector of India's growth and take it to a $200 billion US market by 2030 and we will make innovation the hallmark of this sector. Thank you, Amitabh. Vijay, what's your take on this? You are on mute, Vijay. What Amitabh has done is to really comprehensively state what the situation is now in terms of our tech and pharma and biotech industry and what the way forward is. And, you know, that's really beautifully said and one can't add to that. What I will try and do is to address one of the aspects of your question, which is what does one do going ahead in terms of dealing with future pandemics or future new kinds of ways? Now, one important point to be kept in mind, which you mentioned in respiratory pandemics is no matter what the nature of the epidemic or pandemic, high quality filters in buildings and on people can have an immediate impact, particularly on healthcare workers and frontline workers allowing them to attend to the problem. And this is something which we must understand and scale up nationally and globally. Really HEPA filter added masks of various kinds, which can be used immediately and there should be a market risk mitigation or their widespread dissemination is going to be very, very valuable. Similarly, having hospitals and rooms in a manner which can be completely filtered. The second aspect is surge capacity. You know, surge capacity can deal with about 20, 30, 20 percent at most, but not two or three or four fold increase in requirement. So how does one deal with dramatic increase in requirements? There are rapid approaches to repurposing what is already going on in other sectors, which we have seen happen in the pandemic needs to be amplified and honest. The last point I'd like to mention is in the drugs and pharma industry and the biotech industry. Here, we need to mitigate risk enormously and go through widespread trials for different kinds of potential pathogens for epidemics and pandemics, go through phase one and phase two trials and be ready should an outbreak occur or should an epidemic occur to amplify phase three trials very rapidly. This requires global cooperation. This requires enormous investment in R&D. India has the appetite for that because, you know, these are the kinds of epidemics we've learned from this current pandemic where rapid responses needed are regulatory structure finally has to be changed both in India and abroad in a manner where what took years to take decisions routinely now takes place in months and that's something which you've learned from the pandemic and need to embed it going forward. Thank you. Thank you, Vijay. Amitabh and Vijay very nicely elucidated the next steps and the preparedness that we have to have. Narayesh, you are a doctor, head of Medanta. You have seen how we are struggling to make enough vaccines in India to cover the population in the first round. I know that you're convinced that we need to work on building enough capacity for stockpiling in the future and I'm sure you'll agree that we need to build surveillance and early warning systems for the future pandemics. So how do you think we should shape up our vaccine strategy in the context of our recent learnings and what you have encountered firsthand in Medanta and how do you kind of build on what we heard from Amitabh and Vijay and it'll be important for us to understand what are those post-COVID opportunities that you see through your lens in R&D and manufacturing and how India could be pushed to seriously focus on innovation and R&D. Narayesh, are you on mute? Yes. Sorry about that. So from a provider point of view, what we experienced and what has already some of it has been alluded to by Mr. Khan and Vijay Raghavan is the point for the first time that in the beginning of the pandemic and through the following year and the second wave, there has been a lot of realization of the interdependence of everybody per se but more specifically between all of our sectors that is government, private, innovators, scientists and India did actually come together very nicely to have reached a point where we actually were quite well prepared for the second wave but the happenings between the first and second wave were such that we invited, we invited a very high wave with a huge velocity and perosity and when people say whose fault is it looking to blame somebody, it's all our fault. We all participated in it and we made it happen. So what are the lessons? One is the point which you alluded to, Amitabh also alluded to that we have, do not have today that early warning system. That early warning system is well established, the concept is well established. We have in India the highest capability of producing IT tracking and connectivity. We have a huge broadband network laid by the government at the last level of the village. So all we need to do and I'm sure it's work in progress right now that this data collection from at real time coming into a war room which can actually sensitize ourselves to say where are the danger points and how fast we can react. Don't forget, we have such a huge population that preparation for that stockpiling for that size of population with the amount and number of variety of things that may occur is a daunting task but we should embark on the journey as soon as possible. And what this virus has thrown at us is a twist and turn and surprise at every level. So where we thought that in the first wave we had established enough infrastructure, enough manufacturing capacity to deal with, even if it was double the size but nobody estimated it before time the size to give you an example. The normal oxygen consumption of the medical delivery system in India, non-pandemic was 2,200 tons a day of liquid oxygen. We reached a peak of 10,000 plus tons a day requirement around the country. And I must say there were very difficult times. We spent three weeks, I did not sleep because we had 550 COVID patients and another 250 non-COVID patients in our hospitals and we were looking at two, three hours of supply and at 750 to 800 slides at stake. So it was very harrowing moment but I must compliment the government which I mean not necessary for me to do but I will that the government actually brought together all the resources with participation from industry, from participation from civil society that we were able to overcome it, we lost some but it could have been much huger if we were not that efficient. So let's put that aside, now preparation for the future. So if you historically the waves come between 30 to 35 weeks. So if that is the pattern that this virus is going to follow as happened in the Spanish too which it did in between the first and second wave and we have some breathing time, we need to look at the things that we could do ASAP to one protect the population from the maladies of what we suffered in the second wave. Second is the point, how do we protect across the board? No matter where they reside, no matter what economics data that they are residing that we can vaccinate, vaccinate and vaccinate. So like Mr. Khan said, we have the capacity to go up to 10 million a day. We can do it between the government and the private sector, we have demonstrated. If we can reach that, we can flatten this wave, this wave, the third wave expectation by almost 70%. So we know there are model modulations already done that if we were able to stuck with only 50,000, 500,000 a day, I mean 50 lakhs sorry, 5 billion a day we will flatten the layer or affect the wave by about 25 plus percent. If we can go up to 7 billion a day, we can flatten it below 50% and if we can reach 10 million a day, we would almost flatten it. So we know that the only other thing that we did, we don't want to happen is what that irresponsible COVID behavior. When we talk about responsible COVID behavior, we need to dig it and enforce it completely and that's in the hands of the government and the public and the private civil society to actually follow the rules which will help India to emerge from this malady impact. Because you know another, we may not be able to bear the third wave if it came with this velocity or even higher because of the economic burden and the human burden that we have seen in all this period. So my point is, yes, we need to innovate, we need to create that ecosystem and we must realize it's very easy to say the banner, but research development R&D comes from an ecosystem unless we develop that whole entire ecosystem, we will not be able to be able to really succeed to the level we want to. So we need to look at all the peripheral aspects of supporting R&D and hopefully in the next five years, we would have reached our goal and start full steam to reach that goal of 30, which Amitabh just talked about. So I think India has all the means, India needs to bring in discipline, India needs to bring in the sensing systems of early warnings and also at the same time build a robust R&D system which requires money, which requires the whole ecosystem so the government can actually support hugely in this effort. Thank you. Thank you Nareesh. Thank you very much. Now let me go to Dilip. Dilip, while you can comment on the same point that you heard from, you heard the comments from Amitabh, Vijay and Nareesh, but I'll be very keen to also get your perspective on yet another concept. Many global pharma companies are now seeking to provide equitable access of their innovative drugs through voluntary licensing in India. As an operational CEO of a large pharma company, how do you encourage, how do you think we should encourage more companies and potential licenses to provide broader access to innovative drugs for Indian patients? What would be your recommendations on streamlining the pharmaceutical regulatory process? Thank you Sanat and I think it's been an interesting discussion. You asked very thought-provoking questions. I believe that both Mr. Kanth as well as Mr. Vijay Rajwan have responded to the focus that we as a country have for innovation and how we have managed our pandemic. If I look at as an outsider, then I mean not from medical fraternity. I think two things kind of came out very clearly. One is the speed with which Indian industry responded to the sudden upsurge in the demand for many drugs which were required for treatment of COVID, where in a period of less than four weeks from shortage, products became available off the shelf. Products like industry as well as let's say other drugs used in treatment of COVID. Dr. Trihan talked about the challenge we faced as a country in terms of providing for oxygen and I think he has far more data than what I have. But what I think I can talk about from industry point of view is that many pharmaceutical companies including Sun Pharma, all of us use nitrogen generation plant in our factories and we converted seven of our nitrogen generation plant into oxygen generation plants and shared that with the local hospitals thereby I believe that if all of them have cumulative capacity providing oxygen to more than 1500 patients on a non-wave basis. So I think I saw a clear mix of pragmatic government action at the same point of time. They concerted what you call industry and societal response to the challenge that we faced. I think if many Indians were settled abroad they also sent in a lot of essential treatment options for I believe you were part of one thing to send so many things which were required for patients in India. So I think my belief is that we've managed the first, second wave of pandemic quite well. We're now from a peak of more than 400,000 patients cases every day. We're now less than 50,000 in a period of less than maybe six or seven weeks. So that's a significant reduction and reflects the concerted effort of the government as well as the state governments. Finally I think our industry question you asked is very relevant in a discussion like this because ultimately innovation is what will help us overcome the diseases which are currently inadequately treated and help provide better treatment options for patients. And I think voluntary license is an extremely useful tool for ensuring that the drugs which are required for treating patients, how do we improve the access to those drugs by licensing in many cases at very low royalty or almost more royalty to the industry. As a company Sanfarma I think because we closely work with large number of international companies we have been able to license or we have been a licensee of all the voluntary licenses which companies have given. We've licensed products from Gilead, we've licensed a product for treatment of COVID from Lili and recently I think we also licensed a product from Merck where Merck decided to license this product to eight companies and for the first time in the country I think all of these companies are doing a joint clinical development so that this product can be registered fast in India. I believe that to maintain the future investment in research companies and industry needs to be assured of fair return on their investment but at the same time if some drugs are essential for treating any pandemic or a disease which where access is important a voluntary license will continue to encourage this future investment. We are working with the government to see that because eight is a big number so if there are eight companies marketing this and Lili is also licensed they are very certainly up to six or seven companies so that will ensure easy access to drugs. Hopefully I think we will be able to work with the government to ensure that only voluntary licenses are governed what you call availability of product and not through compulsory license because I believe that compulsory license issued even though only once in the past gives India and Indian companies a bad international name and it needs to be protected at next. Thank you, thank you Vijay, thank you very much. So we got the opportunity to ask this panel questions now let's take the opportunity of going to the audience and ask a few questions get a few questions from the from the audience. There are quite a few important guests we have in the audience so I don't know if they're all on Chris Wiebacher managing partner good net point capital Chris can you hear me? I can thank you Senat and if you can state your question or comment and direct it to a single panelist or you'd like any one of them to comment please state that too thank you Chris please go ahead. Yeah thank you so I have been involved in the global COVAX initiative so I'm looking at this on a more global scale one of the things that we have seen that China and Russia have actually been able to ramp up production of vaccine very significantly and what we see is that the pandemic is not only a health crisis but certain countries are using their vaccine manufacturing in exchange for trade and other geopolitical influence. It's kind of surprising because I would have thought that India would be first out of the gates. Is India now looking at what can India really do to really increase its global vaccine manufacturing which would include having its vaccines registered not only with the WHO under the pre-qualifying mechanism but perhaps the EMA and FDA because there seems to be a huge opportunity for India really to not just serve its own population but to become a global player in the geopolitics of what's going on. Amitabh, Vijay, would you all like to take any one of you? So let me say that our view is that this is not just a pandemic and this is likely to become endemic and therefore India needs to actually build up capacity to produce about 300 million doses a month and that means that we should be able to vaccinate our entire population every four months and then be able to build capacity to export vaccines across the world. Not merely be a powerhouse to meet the needs for the domestic market but look at exporting across the world and that is why we have a range of vaccines presently other than Covaxin and Covishir which is being manufactured by Serum Institute and Bharat Biotech doing Covaxin. We have a range of new vaccines which are coming into India and you have e-biological tie-up with Johnson and Johnson, you have Covaxin with Novavax which Serum Institute is doing, you have Zidas Cadillac coming in with their vaccine which is going to be like soon so we have actually 12 different candidates of vaccines coming in and our expectation is that by December we would have been, we should have been producing, we would have produced close to about close to about 1300 to 1400 million of these COVID vaccines and my personal vision is that India will end up once it has populated, once it has inoculated its own population India will end up exporting to the rest of the world. In fact not merely exporting but it is already exported. India is probably the only country which has demonstrated that you can't be safe if till everybody is not safe and therefore India has actually exported a lot of the vaccines produced in India to other parts of the world and our view is that this is a global fight and globally we have to fight to save the entire humanity. Even one person with COVID in any part of the world will actually be spreading it to other parts of the world. This is not a fight for India producing vaccine, it's about the entire world producing vaccines to save the global humanity and the global community and therefore India will do its best. Indian entrepreneurs are totally top class as far as vaccine manufacturing is concerned. We've been the vaccine factory of the world and we will continue to make manufacturing, continue to innovate, continue to partner with other vaccine manufacturers and continue to enhance our production capacity not only for India but for the rest of the world. Thank you Amitabh. There are two other questions from the audience without and we don't have much time so let me go over to those questions. The next one is from Alka Goyal founding partner Alchemy Growth Capital. Alka can you hear me? Yes I can thank you thank you so much for this opportunity and it's been a very reflective and engaging session so thank you Sanab. Just a little bit of my background so that you understand my vantage point I spent 17 years at McKinsey working in very large companies and now I am running a fund in health and wellness in India so really close to the ground floor on innovation in India just as an example we make three new companies in health care and wellness every week. So my question is actually for Mr. Sanghvi and Dr. Trehan what are the areas that you see technology will have a huge impact from your operating model? Where are you most worried and what are the plans you're making in your businesses to use technology so that we can shape and disrupt health care in the future? Thank you Alka. So one thing that we have seen is a transformation of our entire working model from what we thought would take five seven years to do in the digitization process in the remote delivery space that it all got compressed in a few months. So today just to give you an example pre-COVID we used to do about 100 consultations teleconcerts or video consults with patients remotely. Today we are doing upwards of 700 a day so across all specialties so we see I mean sometimes it becomes very demanding in the sense that as I'm talking to you my secretary just handed me a huge pile of consultations I still have to do through the night. So it has changed no question and it has changed in two ways one of course the multiplier effect that one expert can talk to people anywhere in the country or anywhere in the world. Two it saves the patients so typically if you look at my practice they would have to come with their angiogram pay a visit you'd advise them they'll go home and they would travel from a thousand kilometers or more and they would then you give them a date and they would come and then so it was a huge burden on them time wise effort wise money wise. Today we look at it we are face to face we tell them what we think is the right procedure for them and they come they get a date and they come prepared with everything so you know all these things have made a big difference to give relief from the patient's point of view from medicine point of view it has increased the efficacy and safety for patients like we are doing EICUs so today the multiplier effect of one ICU expert to 10 other ICUs to make rounds with them in the every day is a huge relief so that's one thing that has actually happened now of course we know that AI deep learning virtual reality augmented reality all these things were in the horizon but today all of them have been activated so at that end there is the IT space the other is that how do we increase the safety of the patient as we move forward so there is a lot of innovation we are partnering with with the with companies the startups with biotech companies to say where can we do together development of new modalities to increase the safety of the patient and second is how to to compress research like you see what happened with the vaccine development we know that we are faced with huge challenges by way of not only viruses are transforming bacteria is also transforming and more and more of them will need faster and faster discovery of drugs to handle very serious infections as the population grows older these demands will become much more so I can go on and on and on but no question the face of where we practice medicine where we service patients and the way we look at technology has had a huge transformation that's the upside of this whole malady that we are experiencing thank you Naresh if you don't mind I want to go over to the next question because you're running short of time and this is from Robert Khaliff head of clinical policy and strategy verily and google health Robert can you hear me yes I can hear you just fine can you hear me yes I can please go ahead great so I guess this has been a great discussion I know we're short on time so I'll just ask it quickly obviously you know we're contending with this enormous pandemic and it's been a great discussion of how innovation has made a difference there but we have an even larger wave of chronic disease which is affecting both the US and India you know we're seeing a decline in life expectancy in the US year after year now for six out of the last seven years while India has this enormous population uh coming into the phase of of chronic disease what what are the lessons that have been learned that can be applied to chronic disease from the pandemic I know the time is short so quick answers I know are needed yeah Vijayan to Naresh perhaps this is up your alley well I'll be very very brief so that Naresh can add on from a clinical perspective very simply the idea of chronic disease has got two components one lifestyle and should there be disease then you know delivery of care both require the first requires massive communication and changes in lifestyle to a healthier one the second requires delivery of personalized medicine which in the west is extremely expensive and we need to work out ways to our major national digital health mission other missions to make sure that we can deliver personalized health care in a few go prugal manner that that really is feasible we've learned that you heard from Naresh about some examples but scaling that up will really address chronic disease also Naresh so the seeds of chronic disease are laid from childhood the way the whole thing about building a country's health system was to build that stack and I must say that in the current dispensation from the government the creation of the concept of Ayushma has roots which can actually make a big difference at the ground level so in India of course there's a double opportunity chronic diseases which are lifestyle and chronic diseases which are due to lack of civic amenities so we need to work on both ends Rob and we need to we from this primary health center concept which we call the wellness center once we have enough network we would have actually been able to improve the sanitation the hygiene the nutrition on the ground which is the building block now if you're on the other hand as as we are saying today we are looking at medicine as not only curative not only early detection but preventive and predictive so the question really is when we get to the sophistication of predictive medicine and apply it to our population at large we would have actually made a big difference in the evolving chronic diseases so I think all this thing is in the planning how effectively we execute this is going to be the proof of the pudding thank you thank you very much is any other question anybody else has but thank you all very much it was it was a very good discussion and I really thank the panelists and as I said necessity is the mother of invention we have seen India do a lot of things in the last many years and I'm quite sure in the next years we will see India rising up to the challenge and leading from the front also in the area of innovation thank you all very much thank you thank you Sanat uh wonderful conversation can you put the slide please can you put the polling slide yeah thank you Sanat for a wonderful uh you know excellent you know in depth panel over there can you put the polling slide the poll is now open for a minute please go ahead and start polling we are running bit late so we try to make it up we overshot this panel by seven minutes we have about 40 minutes 40 seconds left question is what does India need to do ensure it is better prepared for the next pandemic we have 30 seconds left it's like a very exciting question the poll is going to end soon thank you the poll has ended we'll see you after four minutes the concept of medanta the desire to build it came from the fact India needed its own institution which would provide the best treatment available anywhere in the world there are four billion people who are in the same shape as indias and if you are going to try to keep copy become a copycat of the western medicine which the americans can't afford themselves it is important for us to develop our own medicine develop therapies equally effective a half the cost pursuant to this vision the medanta research unit is nested within the 1250 beret hospital and conducts clinical trials at a proof of concept phase one unit evaluating vaccines for malaria chicken and several studies in cancer therapies including dendritic cell and immunotherapies phase two clinical trials are of immense interest to expedite access to innovative therapies and the unit also conducts clinical trials for stem cell therapies for cardiac and vascular use newer dressings for reconstructive surgery new drugs and devices team has access also to half a million pathological blocks for biomarker work the recently inaugurated HIPAA compliant tissue repository is currently focusing on breast cancer and rare parathyroid cancers the research team has access to over 3500 outpatient visits 900 hospital admissions and over 75 surgeries a day in this tertiary care hospital several clinical databases and registries have been created and we are the highest asian recruiters in the international registries for aortic dissection we have existing hospital-based vector-borne disease registries and are part of the national cancer grid and the national cancer registries this makes enrollment of patients into clinical trials quick and efficient the research team is also working towards creation of a gcp compliant clinical trial network and has expanded to geographically cover all of india immense focus is on patient safety, antibiotic stewardship and development of clinical decisions support systems we are taking research to the villages through public health programs using various innovations and telemedicine in cancer tuberculosis and vector-borne diseases teams are busy also conducting research in ayurveda looking at well designed randomized controlled trials for classical and proprietary medicine whether for viral diaries or for covid-19 in order to break the barriers to integrating traditional systems of medicine into modern care hello everybody and welcome back sanat big big thanks to you and to the entire panel on india innovation so if we could please bring up the polling question let's see what our audience had to say to the last poll depend on mine and i'm just gonna make that larger on my screen so i can see it there we go sorry there we go so the question that all of you addressed was what does india need to do to better ensure its preparedness for the next pandemic and there was a clear answer with only 50 almost 50 of you thinking believing that in order for india to be better prepared it needs to improve vaccine deployment infrastructure so thank you very much for participating in our poll and as mentioned earlier we will continue with these polling questions throughout the day