 This next panel is gonna be really interesting and chaired by Dr. Andy Plump. The clinical trials in India has been a longstanding topic and it's one where there have been waves of positive, negative intent and follow through in India. Clearly, the population in India is very diverse and the information that comes back from trials can be extraordinarily rich, but there are barriers to overcome and Andy and a really goal-plated panel today will discuss the major issues and opportunities. With that, I'll hand it to Andy. Matai, thank you very much for that introduction and welcome everybody for this really important panel on clinical trial opportunities in India. And before we jump into the panel, I'd like to, and before I introduce the panel participants, we have a special guest and that's Sujay Shetty from PWC. So Sujay actually has been working with us over the past year to put together, thanks Sujay for raising your hand, to put together this, I think you can see it when you get it into the center of my screen, to put together this work that actually is quite extensive that really works through the current state of clinical trials in India. What's working, what are the challenges, what are the perceptions, what are the real barriers? We've been working very closely together over the last year. Sujay has done this with PWC on a pro bono basis and it's quite remarkable the information that's come out. So maybe Sujay, if I may, I'll give you the floor for a few minutes just to walk us through some of the high level observations that you and your team have come up with. Thank you, Andy and Karun and ladies and gentlemen, I'll walk you quickly through our paper, the clinical trial opportunities in India. Next slide please, briefly the paper covers the state of clinical trial activity. It also looks at a lot on the state in India and with respect to the perceptions in the midst and why India went up and down in the clinical trial curve and what's happening on the ground in terms of infrastructure, in terms of access, what might possibly now be a right time to enable innovation in India, not sugarcoating some of the issues but looking at real workarounds and then finally suggesting viable strategies for people who are considering India for a clinical trial strategy. Next slide please. And this is one of the big mysteries of our times. Despite India's position as the world's most populous country, India still contributes an abysmally low number to clinical trial participants and generally in clinical trials itself, it's as low as three to 4% and there's a number of reasons for this. Next slide please. I would belabor all of them but issues like inordinate delays, trial approval times, lack of disease-specific policies, lack of awareness among site investigators, number of investigators, all of those have played the role. We go deep into those issues and see what has happened since in the last decade next to each one of these points. Take a look at successful case studies and experience of those that have had a different experience from these points and what has been the mitigating factors. For example, in terms of delays, we find now that the approval time is comparable to best in class. There's been a 30 to 40% reduction in delays, takes on an average 90 days, which is as good as it can be. And also in terms of the quality of data, we find among some of the more sophisticated trial sponsors that they see the quality of data from Indian sites comparable to those from elsewhere. So we go through that issues. Next slide please. We look at those that enable innovation to happen now. Principally, the three factors. One is with geopolitical risk, you need additional sites because enrollment has been badly impacted. Two, in terms of heterogeneity in trials and the need for diversity in data, the need to include more Asian populations, you do need to have a strategy. And lastly, there's been advances in terms of regulatory developments and infrastructures in India. So bringing them together is a movement in time now that enables innovation of people to look at India more favorably. We look at infrastructure and access across tier one, tier two, tier three cities, development of infrastructure, go deep into the regulatory issues and give a commentary around that. Then finally, we bring it all together. Last slide please. On what strategies trial sponsors can follow in India? They're different ones. You could look at disease-specific categories. You could look at a portfolio-based strategy. You could pursue a niche-buster strategy. All in all, the point the report making is despite noise, there's enough happening on the ground to make India a favorable destination and suggest different strategies that might be used by incoming trial sponsors. Thank you. So we have a really amazing panel here of diverse experts to speak with us. We have Dr. Cindy Verst, who's the head of the president of design and delivery innovation and R&D solutions at IQvia. We have Dr. Narish Trehan, who's the chairman of Medanta. We have Dr. Shiv Sareen, who's the vice chancellor of the Institute of Liver and Biliary Sciences. We have Dr. Vinod Paul, who's a member of the National Institute of Transforming India. And then we have a special guest who'll be the head of the DCGI, which is the India equivalent of the FDA who'll be joining us shortly. And of course, the head of the DCGI, Dr. Trehan Sareen and Paul are all joining us from India where it's about nine and a half hours later. So thank you very much for spending each of your evenings with us. There's a lot to unpack, so I'm gonna ask all of the panelists to please keep their comments crisp, thoughtful, and within a couple of minutes, if you could. And I'm gonna, Cindy, if I may, I'm gonna hand it over to you, your leader in this space and your work in helping to unravel some of the data that tell us where we're headed has been very helpful in the report that Suje just mentioned, but also in our understanding of what opportunities we have in India. So I can hand it over to you to perhaps provide some level setting of where we are, what's happening, what are the data, what's real and what's myth. You got it, Andy, with pleasure. So I'll start off with a few statistics and data sets regarding the volume of clinical trials in India, as well as identifying some of the concerns, namely startup timelines, regulatory approval timelines, and quality. So with those three items in mind, relative to the volume of clinical trials, what we're seeing over a four-year CAGAR, 2018 through 2022, is about a 28% number of clinical trials approved by the regulatory authorities. Now, while 2021 through 2022, we saw a slowdown, there was still a positive increase of about 1.4% of net new incremental trials in India. But importantly, that's against the backdrop of an overall global industry decline by 2% and the number of new starts of clinical trials around the globe. So that's an important metric. And we're also seeing citations like Frost and Sullivan reports, Grandview Research Market Reports, highlighting that there's an intended, our forecast of about an 8% CAGAR through 2025, 2030. And of course, when we think about, okay, what are those therapeutic areas? As Sujay mentioned, we're seeing an incredible increase in global and local trials relative to oncology, CNS, IDV, Cardiovascular to name a few of the growthiest numbers of new clinical trials. But then getting into some of the concerns that we're hearing from our sponsors and cooperating some of these concerns with data sets, startup timelines in particular. And what we're seeing is that a very positive influence of the NDCT regulations that were issued in 2019. In fact, we're seeing startup timelines for India that are now very comparable with the timelines from other key regions. And again, these timelines, regulatory approvals on average about a hundred days and very similar to those on par with the timelines of other key countries like US for central IRB sites, UK, Poland, Bulgaria to name a few. But regulatory timelines debunking that myth, but also there's concerns about quality and what did the data tell us there? Well, regarding quality through industry data on quality and namely through the US FDA inspection data actually reflect quality of India sites, not materially different from global site findings. And in fact, from my QVIA data sets, we're finding very similar quality findings in so much as we name it quality index. And that is we look at things like GCP compliance metrics, protocol deviation metrics, other parameters. And indeed similar, we're finding those data sets very comparable to global findings and pan Asian findings. So Andy, back to you, just a level setting with some global impressions. Thanks, Indian. And as we've discussed, it's let the facts do the talking and the facts tell us that there's just a huge opportunity in India and a lot of what's perhaps a lot of the barriers that exist are perceived in myth and not fact. So thank you. So Dr. Paul, thank you so much for joining us. It's just a privilege to have you on this panel. Dr. Paul is a member of the National Institution for Transforming India. Dr. Paul, if you could share with us a bit, provide a bit of sense for what's happening in India in terms of the economic environment and the healthcare environment, what are the trends that we're looking at today? Thank you, Andrew. Thank you very much. Pleased to be in this August panel. Well, India is the fastest growing large economy. It was so before the pandemic and it continues to be so at present and it will continue to be so in future. We are pharmacy of the world. We are vaccine hub of the world. We would like to see ourselves as diagnostics hub of the world as well as medical devices hub of the world. You are aware, I'm sure that India consumed or administered 2.2 billion plus doses of COVID-19 vaccine, all of those doses were made on the soil of India. We licensed seven vaccines for COVID-19 and they belong to all the four or five, all the platforms. Perhaps no other nation has all the platforms than this large number of licensed vaccines. I want to add here that in our journey for vaccine development, in the midst of raging pandemic, clinical trials were done for as many as 24,000 subjects for our co-vaccine vaccine and the DNA vaccine, 28,000 subjects shows the capacity to undertake large scale trials on the ground. I also want to add that for many of these vaccine, the assays were done in national laboratories spread over the length and breadth of our nation. So, whatever may be the vaccine per se, but immunological studies, the T3 function, T cell function studies, virological studies were being conducted in the national laboratories, the public sector laboratory, just to indicate the system that we have. In recent times, there are significant developments with regard to the regulatory framework, specifics of regulatory changes or foresight will come from my distinguished colleague, Dr. Rajiv Singh, Dr. Rajiv Rajwanshiji, our DCGI. But let me add the following information. One, that we two days ago, well, one week ago now, a new biomedical devices policy has been unveiled by the government of India. A new drugs, medical devices and cosmetics act is on the end bill, which will further create facilitatory pathways for R&D and clinical trials included. We are in the midst of biopharma mission already from the DBT department of biotechnology and a policy on research and development in the pharma and medical devices sector, the specific policy is in the final stages of its evolution. In brief, what we're trying to convey is that we are conscious of creating an ecosystem that promotes the aspiration, our aspiration to have a very strong contribution of the pharma devices and medical technology sector in India. I'd like to add here what I stated last time on this forum, that we would encourage you to not to go to small cities and small nursing homes for trials. Please use our good agencies and good offices to go for trials from reputed, well-entrenched, scientifically strong institutions, particularly our center of excellence. In this regard, I'm happy to inform you that the Indian Council of Medical Research under the new director general is creating an ecosystem in such a way that you can reach us and we can help you to get connected with such entities and groups and PIs and institutions, apart from what the Department of Biotechnology is already doing. So we'd encourage you to reach out to academia. We'll encourage you to reach out to industry through the government channels, if that is needed. And we'll be very delighted to contribute toward field trials on the sites that we have specifically created for vaccine development which were made use of in the vaccine arena for COVID-19. Last but not the least, I would like to say that we stand committed to make India as a hub of ethical clinical trials. We wish to contribute toward discovery of new molecules, new uses, and for cutting edge technologies, the gene-based therapies at CAR-T cell-like therapies, we are looking forward to hearing from you what other pathways must be innovated because these are different entities, these are different technologies, different solutions and therapies. We'll be happy to work with you to see how for those cutting edge technologies, further modification of the regulatory system should be undertaken. Indeed, looking forward to connecting and following up on the discussions and the decisions that you take on this forum in partnership with our distinguished colleagues in the private sector, in the industry, and within the government. Thank you very much. Yeah, Dr. Paul, thank you so much. Thank you for those really thoughtful comments. Thanks for the partnership. Thanks for the inquiry in asking how we can work better together and thanks for the invitation to do more in India. It's really terrific and the progress that's been made is quite remarkable. So now I'm gonna turn to two of our other panelists, Dr. Sarin and Trehan. And I'll start with you, Dr. Sarin. And I hope that you had a good day and are finished with your endoscopies for the day. Dr. Sarin is an innovator and also a practicing gastroenterologist. So Dr. Sarin and Trehan, to perhaps provide some perspective of what's happening within each of the settings in which they spend their days. Dr. Sarin at a public hospital and Dr. Trehan in a private hospital. So Dr. Sarin, I'll hand it over to you first. Thank you. So first of all, let me compliment Karun and you, Andy, for the fact that you people have actually created this platform year after year to actually bring us all together to be able to showcase what is the current status of clinical trials, innovation in India. So as the stage has been set by the previous speakers, Sojoy, Dr. Verti and Dr. Paul, most importantly, and we have also the seriousness. You can see Dr. Rajiv Singh is also there. He's our new DCGI. So all this just shows you there are two things. One, let me put it in perspective the way I see it. One, all the questions that were actually raised and that Sojoy very eloquently put it answered them on the right column. And it's true that India required a real revamp in 2013 of our regulatory system for clinical trials because it was almost non-existent. And then it took five years very deliberately that we actually produce the competing on what the clinical trial regulation should be. And in 2019, it was actually announced and it is by all means was welcomed by most people. There were a little bit one or two areas of concern which we have addressed. And so what has happened now and also then pandemic hit and it also showed the weakness in the world and also the strengths in the world. Like India came out with all the, as Dr. Paul has already enumerated. So what are the advantages been there? First of all, one of the criticism that was was the integrity of the data. Integrity of data depends on who you engage with. There are now in the last five years or so there are several institutions including ours that's Medanta. We have five hospitals, close to 3,000 beds under our banner. Another thousand beds coming online by the end of the year. That we have, we are JCI approved. We are named as the best private hospital by Newsweek International for four years in a row. And that didn't happen that because we don't have the sanctity of the data and the work we do. So that's why these examples are not only with us but many other institutions. There are government, there are other private institutions. So we value our reputation, we value our data. We value the research that we do and the outcomes we have because we then are the beneficiaries or the victims of it. So one thing the world should be very clear about that the landscape has changed for the better. And as Dr. Vorty said, some of the things that were compared in study actually compared India well to the rest of the world, which is so and as you know that the government of India's policies and like I said, the seriousness is on the screen itself is to actually change India to center stage as far as all the things that Dr. Paul enumerated as the pharmacy of the world, the medtech, all the innovation of the world because it's possible. We have the IT structures, we have the brains, we have the will to do it. And now we have the facilities and we also are blessed with the most diverse gene pool. So having made a case for it, we can tell you that like the government is actually encouraging a lot of research also that department of biotechnology has given us many trials for Medanta. They are very closely monitored and the data integrity checked on its own. The ICMR has approved many of our trials and followed and evaluated our data. So one, I can make a pitch for Medanta but I'm making a pitch for India because we are not alone in this situation. And I think that whole figure of 4% of the world trials being done in India could be changed to the advantage of the world in very short order. So thank you for this opportunity and the possibility of stating just in sequence of what has been said before and then said, let's enhance it because we have some great advantages with the rest of the world doesn't. Well, maybe with the comments, thank you for helping us understand what Medanta has to offer. And then you've opened it up to the broader India community and that's a great lead. And then to you, Dr. Saran, tell us a little bit about the hospital that you work at and the opportunities there. Thank you, Andrew. And thank you, Karun for inviting. The problem of five and 95, India has 95% of preventable deaths, but only 5% of the trials come to India, which is a pity. With the highest FDA approved manufacturing units, the best speaking English doctors around, we still don't have the trials. So it is for you and the US people to see and the platform has been very well set. At ILBS, the Institute for Liver and Biliary Sciences, we have a monthly ethics committee and we have just done the 100. In 10 years, we have 100 such meetings, the largest number of clinical trials. For example, for no artist, the debut 025 and for the other NASH trials, GLP, when we are the largest recruiters in the world. Now, I have a few suggestions and thoughts. First is we have lots of screen failures and since India is here, the screen failures are because we get the blood here and they are shipped out. And I have a feeling we need to improve that screen failures. Partly could be the CROs that we get in India, which need to be improved. Second, we have a problem of, which we can solve is going to different cities. And as Dr. Paul also said, we can have city clusters like Delhi, like for example, Mumbai and city clusters, you can have a large network that we regularly follow. Third is, can the FDA and Dr. Rajeev is here, can the FDA and the DCGI have an MOU, like we have G20. So anything which has been approved by FDA can be accepted with discussions rather than an ethics committee of every single drug. And I think in G20, this can be done that ethically we can approve all the broad principle for drugs and it will facilitate like we can have. We don't have to say Indians are used as guinea pigs, but we can have same standards. We accept the degrees from the West. We also need that, and we proposed it about seven, eight years ago, licensed clinical trial. Like you have medical license, you get a license for doing clinical trials. I think these are some suggestions. We have 10,000 cardiologists enrolled, 10,000 hepatologists enrolled, and you have a list which is available to us. One last point which I would like is you tell us what more we need. We keep harping that we are good, but you tell us, Andy and all others, that you need this much more and then you will come. And I think the ground will be laid with a red carpet, but we should start today, there is no tomorrow. Well, thank you very much, Dr. Srin for those comments and that invitation. Let me first apologize and secondly, turn it over to our last panelist, which is Dr. Badri Srinivasan. Badri, I'm very sorry that I didn't announce you at the very beginning. I didn't see you on the video and so I have my apologies, but Dr. Srinivasan is the head of global clinical trial operations at Novartis and actually is leading the industry in terms of engaging in India site. So Dr. Srinivasan, if you could just share with us a little bit your perspective from a pharmaceutical company of what you're seeing in India, why you've stepped in as you have and what you need to do even more in India. And maybe you can also help put a little bit of perspective around where India is with respect to the rest of the world. Andy, thank you very much and no apology needed. I just wasn't sure if I was still a panelist or not, but absolutely fine. Absolutely a panelist. No worries, no worries at all. And thank you, thanks for the leading and thanks for the brief there. As a, maybe I'll talk about it in two perspectives as a large pharmaceutical company and then also in terms of how we see India as you rightly said. First of all, and also Dr. Srinivasan already said about the Nash trials and the enrollment for Novartis. So as is evident, Novartis already has a huge presence in India. For us as a large company, we look at India very much as a strategic location just as we look at any other location around the world, perhaps increasingly so given that companies like ours are going more and more into often rare diseases, diseases with areas with high disease burden with the increasing need for diversity and inclusion in trials. And also we see increasingly clinical trial as a care option for many, many patients. So for us, India is a huge presence. We have, as we speak actually, we have over 50, somewhere like 55 trials that are going on in India. We have over the course of just the last few years we've recruited over 10,000 patients in India. As we see instability in various areas around the world, geographies around the world, India has stepped in and a large portion of the gap has been filled by India. We also, not just in clinical trials, I would be remiss if I don't mention the full spectrum. We actually see India as the full spectrum of clinical trials. So we have in India right from protocol writing to clinicians, to everything from data managers, regulatory specialists, our technical research and development team, as well as medical writers, submissions, we handle a lot of our submissions including things like ad comms and stuff like that from the FDA from India. So for us, India is a huge strategic location. And we've done that. And as many of you, if not most of you know, we have a huge presence in Hyderabad over 2,400, 500 people there just in our development unit. But we've done that because we've seen an improvement in the regulatory landscape in India. We've seen the maturity of sites in India that are able to handle complicated protocols and ever more demanding diseases, if you will, or disease management. We've seen the maturity of hospital systems, the embedding of ICH GCP, where I know many years ago, it used to be ICH training, GCP training, not so India is very much on par with the rest of the world. There was a lot of discussion about data quality. For us, we do not see a differential data quality coming out of India. Data quality is just as good coming out of India. Data timeliness is just as good coming out of the sites in India. The ability to handle more and more cutting edge systems for data, not just CRF instruments but also devices, things that are mobile units, et cetera, is very much high. So the data science maturity actually helps in the clinical trial handling maturity as well. So it's a perhaps a long way of me saying that India is a robust place for us. That is not to say that there are not challenges. We would like to see a continued improvement in the ability to start up trials in India, continued improvement or streamlining, if you will, of the regulatory landscape along the lines of the improvements already done. Talent management in clinical trials is a huge area of concern for us. And what can we do as India as companies in India such as ours to ensure high quality talent that results in high quality clinical trials in India as well. Maybe I will leave it there and hand it back over to you. And you're on mute, by the way. Well, thank you. Thank you, Bobby. A rookie mistake. So actually you're on mute, but if you could just come off, I want to just ask you one follow-on question. Firstly, your comments are very powerful and meaningful. If there's one area in terms of regulatory, continued regulatory reform, which you mentioned is something that you'd like to see, what's one area that you'd point to specifically? I would, despite, I know Cindy Wurst, Dr. Wurst mentioned about the startup timelines, despite that I would still say our ability to start up trials very quickly in India means that India can be a competitive recruitment player. Because when I have a situation where a study needs X number of patients and we are hitting the end of enrollment, then we face a problem where India then gets, perhaps not able to contribute the number of patients, it could have contributed. So I think if we can start up trials, which is a phase where we get from the protocol to first patient, first visit, that would be tremendously beneficial for us to keep increasing India's contribution. That's great. Well, listen, I hope that there are members from my clinical operations team that are watching and listening to you because I think we've been underperforming in missing an opportunity in India and not living up to our obligations as a healthcare provider. You are offering great hope. Maybe Cindy, I'm gonna turn it to you and then we have a special guest so I'm gonna turn to you in just a second. And perhaps from your perspective, having heard everything and being a leader in this space, maybe you can help to summarize what you see of as, again, the major myths that are creating barriers and then perhaps what you continue to see as some of the challenges that need to be improved upon in India. Yeah, I'll be brief, Andy. I think myths, we've already accomplished it and Bodri further underscored some of the myths, but I would say from a challenge point of view and over the same 2018 to 2022 time period, large pharma, mid-tier pharma and even emerging biopharma, what we're hearing and it's important on the emerging biopharma side because we're seeing a 30% increase of that emerging biopharma coming into India for clinical trials. And essentially some of the challenges that we're hearing across the board, all sponsor segmentations included is this whole notion of the intent to market in India. So essentially the regulations highlighting that sponsors wanting to include Indian clinical trials that they are committing to commercializing their product. So that's one additional challenge that we're seeing. And the other is IP protection. So sponsors are still very concerned across all segments about IP protection, but another data point that we've highlighted and that is from 2006 to 2012, there was a, when thinking about the IP issues as a proportion of launches, about there's been a decrease of these issues from 15% in 2006 to 2012 to less than 5% in 2013 through 2021. So again, just some challenges with a few data points associated. Terrific, thank you very much. So let me at this point introduce our special guest, Dr. Raghuvavanchi, who's the commissioner, the director, controller general of India, which is the equivalent of the FDA. And firstly, congratulations and thank you for everything that you've done in terms of accelerating the landscape to you and all of your colleagues. So maybe we don't have a lot of time. So maybe just in a few minutes, maybe some of your perspectives on where the state of today in India. So thanks a lot, Andrew, for giving this opportunity and thanks to Dr. Paul also for pulling me in. So as the previous speaker said that the new NDCT rule came into enforcement on 19th of March, 1990, 2019. And since then, a lot of improvement has happened in the complete atmosphere and the conductance of the clinical trials, what we are doing in India. And for the benefit of everybody I present here today, one data point which I can give you that in 2012 we had 96 applications, global trial applications. These are not the domestic trial applications. And by December of 2022, we had 186 global trial applications. So it was more than double in about five years. And I think the same trend will increase in terms of whatever NOC we granted, there is an improvement of about 20% since 2017. So that data speaks that the world is actually recognizing the change and the more and more global clinical trials are coming to India. Some of the salient features which we bought in the new clinical trial rules, which is actually facilitating more and more and increasing the confidence globally, is we have bought the deemed to be approved timeline driven approval systems in the clinical trial applications. And some of the part we have to approve in 30 days, otherwise it will be deemed to be approved. And similarly in some of the sections is the 90 days is the time period which has given to regulator. The academic trials, we do not need the CDSCO permission, it can be done locally through the ethics committee of the hospital or the institute doing it. So that we have completely separated from CDSCO permissions. The provisions of accelerated approval is there in specific cases of rare diseases. And similarly, there are many new provisions which we bought in the new trials. And it actually gels with the government of India's intent to keep the position of pharmacy of the world and increase the confidence of the world towards India in the pharmaceutical domain. And we are always available, I recently joined, but the organization has become much more open now. You can, anybody can approach me or my colleagues and we respond and we give these suggestions wherever is required. But having said that, I appreciate and I accept that there are a lot of improvement areas where everybody together, including the ministry support, Dr. Paul's organization support, we are improving day by day and I'm sure your expectation will be met in time to come. Thanks a lot, I can answer if you have any questions. Thank you, Dr. Agavanshe for joining us in such late notice. And I think we need a PR campaign to celebrate and to highlight all of the policy reforms that have happened. And we've seen this in China over the last decade or so and there's been a lot of press around the evolution of the regulatory landscape in China. It's equal to or better in India. And I think that the word just hasn't gotten out. I think we have time for maybe one question and I know we have a couple of members of our audience. Maybe either Amit or Robert, one of you can take the floor and ask your question. Sure, hi everyone, I'm Rob Lenz, a head up development at Amgen. So maybe I'll bring a perspective of a company who isn't currently conducting clinical trials in India and obviously the opportunity is enormous. It's been fantastic to hear the progress. So maybe if I could just ask some of the panelists, maybe Bodri or Cindy, those of you who have extensive experience there, what advice can you give to companies that are contemplating either re-entering into China since closing out after 2018 or for the first time entering into China in the clinical trial space? India, right? I'm sorry, India. You got me. You got me. Let's check the right panel. Yeah, you got me in China with your comment. Sorry, India. Bodri, why don't you go for it? I was gonna say it simply because I think her experience far outweighs mine. Yeah, but happy to. Couple of things. One is maybe the obvious, but I would say if you're gonna enter India, don't do it half-hearted. Go all in because I think stepping in and testing toes in the water, et cetera, has been done by a number of companies. And I think going in there and saying, this is what we're coming to India. This is what we need from India, et cetera, et cetera, I think would be very powerful but also really get the machine cranking. That's number one. Number two, I would be also very careful and selective about the disease areas you choose initially to go into India. To choose a disease area that is perhaps better done outside India and to bring it into India perhaps would be a, may result in difficulties and that may then reflect poorly on India. I would be, do your feasibility work, if you will, carefully and then go into those areas in India with full gusto, so to speak. That's great. Thank you, Badri. Actually, we do have time for one more question and I think Amit, are you still on the line Amit? Yeah, there you go. Amit, if you would mind just quickly asking your question. Yeah. There is a very enabling environment right now to do research and find questions for our own problem. So my question is, what advice you will give to young researchers, especially in public sector in India, who are looking to collaborate with CROS and sponsors to do clinical trials that cater to the health needs and priorities of Indian population. Great. I think there's so many that can answer. Dr. Sarin, if I may turn to you, Sivin, you can perhaps give a brief answer to that question to the panel. Well, I'm not very sure. The young investigators, I think all of us are young and we feel young. As long as the research question is good and it is a passion and research is a religion, so we practice it. I only have one additional point for all the wise people. Why are there no investigator initiated or India-based trials designed in India we always get to participate in a trial which has been designed somewhere else. Can you not think of, we have the ground, we have the metal, you can test it, and also there could be a huge enthusiasm. You will have a network of hundreds of clinicians. Thank you. Great. Thank you very much, Dr. Sarin, Trayhan, Dr. Paul, Dr. Raghavanshi, Dr. Verz, Dr. Srinivasa. Thank you so much all for a terrific panel. Really appreciate it. And now if I could ask our technical group to please pull up the polling question that follows this panel. Good. So I'm just going to try to make this larger so I can see it on my screen. And there we go. Good. So here's the question, the polling question is, and then please, we encourage all of the audience to answer. What do you most expect to see over the next year? A, more clinical trials conducted in India by Western biopharma companies than in the prior year? B, roughly the same number of clinical trials conducted in India by Western biopharma companies or C, less clinical trials conducted in India. So please complete the poll. We'll actually see what your answers are in just a few minutes. Thank you. Thank you, Andy. We have about a minute to cast your vote. Please go ahead and start casting. It's open for the next 60 seconds before we close the vote. And the results will be announced in the next few minutes before the start of the next panel. Thank you very much. We're back now. Let's look at the results from the most recent poll. If we could please have the panel put up actually. So I'm going to try to, there we go. Let me just pull these up and we actually have another clear winner. This is great actually that we're differentiating in the polls this year. And I think the panel was quite effective. So the answer is, what do you expect to see over the next year in terms of clinical trial activity and really overwhelmingly our respondents feel that there'll be more clinical trials conducting any. I really hope that that's the case because there's just such a huge opportunity for us to make such a big difference.