Gene Editing has always been one of the intriguing topics amongst research scientists who are in constant inquisitiveness to know the enhanced human health. Every other outbreak of a deadly disease drives emphasis of scientific research towards Genomic studies and alteration of even more.  CRISPR-Cas 9 has emerged as a magic potion that has aided in such directed scientific research and studies whilst promising a revolutionary future in human health and medicine. As uncanny as it sounds, CRISPR-Cas9 is an intricate, high throughput technique that is the most sought after amongst Molecular biologists. 

CRISPR stands for Clustered Regularly Interspaced Short Palindromic Repeat and Cas-9 stands for CRISPR associated endonuclease-9. The technique marks a significant genetic tool that helps in substantial modification of genomic sequences of human DNA aiding in correction of potential diseases and genetic defects that an individual might be subjected to. The inspiration for the technique goes well beyond our imagination as something as wide-ranging as CRISPR-Cas9 was adapted based on a self-immune defense mechanism naturally occurring in micro creatures like bacteria against viral attack. The mechanism enables bacterial creatures to capture the viral DNA segments and integrate them into their own in a manner that creates segments known as CRISPR arrays. Then, the bacteria sustains a memory of the viral attack in the form of CRISPR arrays and allows generation of respective RNA segments, recognizing and attaching to the viral DNA which is further spliced by Cas-9 enzyme thus disrupting the virus, during the next attack.  

CRISPR-Cas9 has successfully aided in genome editing in plants giving rise to gene knockout mutants that would, otherwise, have been a great deal of time through conventional breeding methods.

The technique possesses widespread implications in plant science research, specifically crop improvement, which is one of the crucial concerns of today’s era. The crop health is vital for a healthy mankind which necessitates use of such revolutionary genetic tools to enhance crop quality and lessen susceptibility to diseases. CRISPR-Cas9 has successfully aided in genome editing in plants giving rise to gene knockout mutants that would, otherwise, have been a great deal of time through conventional breeding methods. Besides doing wonders in Gene Therapy, CRISPR-Cas9 has proven efficiency in all sorts of genetic alterations such as Gene Activation and Silencing and production of Gene knock-in and knock-out mutants for research purposes.

While hailing this technique for scientific research in Human health and medicine, the potential concerns associated with it can’t be overlooked. The CRISPR-Cas9 based DNA editing, however currently restricts Genome modifications to somatic cells and refrains its implications to germ cells which would significantly infer the changes being passed on to the future generations. But the ever-transforming era that we currently are surviving in, we are not very far from witnessing such techniques being utilized to all possible extents including germ cells for mercenary gains. The possibilities would include enhancing or altering normal human traits (such as height, IQ or skin colour) based on personal preference. Considering the bright prospects that CRISPR-Cas9 in gene editing holds, it is yet another important aspect to establish a well-planned set of ethical rules and regulations or code of conduct to be always implemented in all research workplaces carrying out such intensive research-based techniques. The gene editing technique utilizing CRISPR-Cas9 is though one of the most explored techniques by research scientists but still holds extensive potential in Animal and Plant Biotechnology for improved health of mankind.

“Composed by: Aakriti Sharma, an aspiring Biotechnologist from Delhi, India. She is an avid reader, a passionate writer and a consultant in the IP domain. Belonging to scientific background has always inspired her to embrace even the smallest things in life based on her scientific acumen.”

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India’s One Health policy agenda, is a proactive response to the increasing threat of zoonotic diseases and the growing realisation that human health cannot be separated from animal health and environmental conditions. The policy seeks to provide a comprehensive approach to prevent, detect, and respond to these emerging threats, focusing on strengthening surveillance systems, enhancing laboratory capacity, building human resources, and improving community engagement.

Implementing the One Health approach in India, requires significant coordination between various governmental departments and stakeholder groups. It also demands an understanding and acknowledgment of the social, economic, and environmental determinants of health. This approach necessitates collaboration between veterinarians, physicians, environmental scientists, public health professionals, policy-makers, and community members to create effective solutions that benefit all species and the environment.

Karnataka, one of India’s southern states, is leading the way in piloting One Health programs. Karnataka is among two states hosting One Health pilot projects with a focus on zoonotic diseases. This initiative is aimed at understanding the complex interaction between human and animal health within a shared environment, thus contributing to a more comprehensive approach to disease control and prevention.

Moreover, India is not only focusing on domestic policy changes, the nation is also contributing to a shift in the global paradigm by pushing for the recognition of One Health at international forums. The aim is to share India’s experiences and learning with the world, thus strengthening international cooperation and global response to health challenges that transcend national boundaries.

India’s involvement in One Health advocacy is key to protect not only its inhabitants but the world at large. It signifies a move from a reactionary model to a more holistic, preventive one that respects and nurtures the health interconnections between humans, animals, and the environment.

However, the successful implementation of the One Health approach in India, like anywhere else, depends on overcoming challenges such as funding, policy integration, capacity building, and awareness. With a concerted effort from all sectors of society, India can help lead the way in demonstrating the effectiveness of the One Health approach in safeguarding planetary health.

Integrated Disease Surveillance Programme (IDSP): A Step Towards One Health

The Integrated Disease Surveillance Programme (IDSP) was launched by India’s Ministry of Health and Family Welfare in 2004 with the aim of establishing a comprehensive system for detecting and responding to disease threats. It was designed to monitor and track diseases that could potentially lead to outbreaks or public health emergencies.

The IDSP employs a decentralised, state-based surveillance system for the timely and efficient collection and transfer of data related to diseases. It takes into account both human and animal health data, which is crucial in controlling and preventing the spread of zoonotic diseases. The program utilises an integrated approach, linking local, district, state, and national levels to detect early warning signals of impending outbreaks and initiate a rapid response to control the spread of diseases.

This initiative, therefore, forms a significant part of India’s One Health strategy, as it recognizes and addresses the interconnectedness of human, animal, and environmental health in preventing and controlling disease spread.

The Role of ICMR’s Zoonoses Division in Addressing One Health Issues

The Zoonoses Division of the Indian Council of Medical Research (ICMR) plays a pivotal role in addressing One Health issues. It is dedicated to the study and research of zoonotic diseases, which are diseases that can be transmitted from animals to humans, such as avian influenza, rabies, and brucellosis.

The division carries out epidemiological studies to track the spread of these diseases, develops diagnostic tools and treatment methods, and conducts research to understand how these diseases are transmitted between animals and humans. It also contributes to the formulation of national guidelines and policies for the control and prevention of zoonotic diseases.

Thus, the Zoonoses Division plays an important role in implementing the One Health approach in India, bringing together human and animal health sectors to mitigate the risk of zoonotic diseases.

India’s International Collaborations for One Health

India’s engagement with the One Health initiative extends beyond its borders through collaborations with various international organisations. These collaborations enable knowledge sharing, capacity building, and the leveraging of resources to address health challenges more effectively.

For example, India works closely with the World Health Organization (WHO) on a number of health issues, including disease surveillance and response, the prevention and control of zoonotic diseases, and public health emergencies.

India also collaborates with the Food and Agriculture Organization (FAO) and the World Organisation for Animal Health (OIE) to address animal health issues and their implications for human health. These collaborations focus on improving animal health services, controlling and eradicating animal diseases, and promoting safe food production systems.

Furthermore, India is a member of the Global Health Security Agenda (GHSA), an international partnership that seeks to strengthen countries’ capacity to prevent, detect, and respond to infectious disease threats. Through the GHSA, India collaborates with other countries to enhance its own capacity to handle health threats and contribute to global health security. These collaborations underscore India’s commitment to the One Health approach and its role in advocating for global health.

Navigating the Roadblocks: Implementing One Health Strategies in India

Implementing One Health strategies in India presents a unique set of challenges, from fragmented jurisdiction to resource constraints and public awareness gaps. Following are the major roadblocks in implementing one health strategies in India:

Fragmentation and Jurisdiction Overlaps: One Health involves a collaborative approach across different sectors, including human health, animal health, and environmental health. In India, these sectors are managed by different governmental departments, each with its own jurisdiction. This often leads to overlaps, inadequate coordination, and a lack of information exchange between these sectors, which can hinder the effective implementation of One Health strategies.

Limited Resources: One Health strategies require substantial funding to support research, capacity building, disease surveillance, and response systems. India, like many other developing countries, faces challenges related to limited resources and funding. In addition to this, there is a scarcity of skilled professionals who are trained in the One Health approach, further impeding the effective execution of these strategies.

Insufficient Public Awareness: Many people, including healthcare professionals and the general public, have limited understanding of the concept and importance of One Health. This lack of awareness can make it difficult to effectively implement One Health strategies and can lead to resistance or non-compliance with public health measures.

Limited Research and Data: There is a lack of comprehensive research examining the interconnection between human, animal, and environmental health in the Indian context. This limited data hinders the understanding, planning, and implementation of One Health strategies.

Weak Surveillance Systems: Effective implementation of One Health strategies requires strong surveillance systems to monitor and respond to potential health threats. However, India’s current surveillance systems may not be adequately equipped to detect and respond quickly to outbreaks of zoonotic diseases, which can jump from animals to humans.

Addressing these challenges requires a multifaceted approach that includes policy reforms, increased funding, enhancing public awareness, promoting research, and strengthening disease surveillance systems. Overcoming these hurdles is critical for India to effectively implement One Health strategies and safeguard the health of its people, animals, and environment.

Overpowering Constraints in Executing One Health Initiatives in India

Addressing the roadblocks in the execution of One Health strategies in India requires a comprehensive and multi-pronged plan that includes policy modifications, a boost in funding, initiatives to improve education and awareness, and an upgrade in surveillance systems. Let’s delve deeper into these key elements:

Creation of a Unified One Health Centre: An integrated system fostering inter-departmental coordination can significantly enhance the execution of One Health in India. This centre would assemble experts from varying sectors, such as human health, animal health, and environmental health, thereby augmenting the efficiency of strategic planning, communication, and response to health threats.

Expansion of Resource Provision: Sufficient financial and human resources are indispensable for the effective operation of One Health strategies. By scaling up the budget for research, infrastructure, and skill-enhancement programs, India can augment its potential to tackle health threats. Furthermore, training a broader range of professionals in the field of One Health can help bridge the gap of skilled personnel.

Amplification of Public Consciousness and Education: Elevating the understanding of One Health among the public and healthcare professionals is crucial. Integrating One Health principles into educational curricula of medicine, veterinary science, and public health programs can nurture a new cadre of professionals well-equipped in these principles. Concurrently, public awareness drives can help disseminate knowledge and foster acceptance of the One Health approach among the masses.

Fortification of Surveillance Mechanisms: Upgrading disease surveillance mechanisms is key to promptly detecting and responding to potential health threats. Technological advancements and data analytics can be leveraged to enhance the ability of surveillance systems to identify and monitor disease outbreaks effectively. International collaboration can also help boost India’s surveillance capabilities.

Advancement of Research and Development: Promoting extensive research into zoonotic diseases and health’s ecological aspects can help refine the application of One Health strategies in India. Additionally, the development of innovative tools, such as new diagnostic methods and vaccines, can contribute to more effective disease prevention and control.

Encouraging International Cooperation: India should continue fostering partnerships with international organisations and other nations to exchange knowledge, learn from successful practices, and collaborate on addressing common health threats. These partnerships can amplify India’s capacity to effectively implement One Health strategies.

Implementing the One Health initiative in India requires a well-planned and coordinated approach. Here are some suggestions for ensuring a smooth execution:

Interdisciplinary Collaboration: Strengthen collaboration between veterinarians, human health professionals, ecologists, and others to address health issues from a holistic perspective. Encourage knowledge sharing between these different fields and promote the development of cross-disciplinary teams.

Policy Integration: Ensure that One Health principles are integrated into the policies of all relevant departments. This includes health, environment, agriculture, and rural development. Policies should be harmonised to prevent conflict and to promote the simultaneous achievement of human, animal, and environmental health goals.

Strengthen Surveillance Systems: Improve surveillance and diagnostic systems to promptly identify and respond to potential health threats. This includes enhancing the capability to identify new zoonotic diseases and monitor their spread.

Capacity Building: Train health professionals, researchers, policy-makers, and community workers in the principles of One Health. Encourage the development of skills that are necessary for the implementation of One Health policies, such as disease surveillance, risk assessment, and interdepartmental communication.

Community Engagement: Raise awareness of the One Health concept among communities, particularly those in rural and semi-rural areas where human and animal interactions are high. Involve communities in decision-making processes to ensure that policies are culturally appropriate and effective.

Research and Innovation: Invest in research to understand the complex interplay between human, animal, and environmental health. Use these insights to drive policy decisions and develop innovative solutions to health challenges.

Collaboration with International Bodies: Partner with international bodies such as the World Health Organization, World Organisation for Animal Health, and the United Nations Environment Programme. Collaborate to share knowledge, best practices, and to coordinate responses to global health threats.

Adequate Funding: Secure sustainable funding for One Health initiatives. This could be achieved through government funding, public-private partnerships, or international grants.

By addressing these key areas, India can create a strong foundation for the implementation of the One Health initiative, ensuring a healthier future for its people, animals, and environment.

Educational Initiatives: Fostering a New Generation of One Health Professionals

Education is a cornerstone of India’s strategy to promote the One Health approach. Several universities and research institutions across the country have started offering courses and programs that focus on One Health. These educational initiatives aim to train students to understand the interconnectedness of human, animal, and environmental health and equip them with the skills necessary to address health challenges from a holistic perspective.

Moreover, there are also ongoing efforts to incorporate One Health principles into the curriculum of medical, veterinary, environmental science, and public health programs. This is complemented by awareness campaigns designed to educate the public about the importance of One Health.

Future Steps: Building a Resilient One Health System

In the face of these challenges, India is taking steps to build a resilient One Health system. One of the critical future strategies is to establish a National One Health Hub. This would serve as a centralised system that brings together professionals from human health, animal health, and environmental health sectors. By integrating these different sectors, the hub aims to improve coordination, facilitate rapid responses to health threats, and promote an efficient exchange of information.

The government also plans to strengthen surveillance mechanisms and enhance laboratory capacities to better detect and respond to potential outbreaks of zoonotic diseases. Another important measure is to increase funding for One Health initiatives, including research, infrastructure, and capacity-building programs.

Conclusion: India’s Growing Influence in Global One Health Advocacy

Despite the challenges, India’s efforts towards advocating for and implementing the One Health strategy are having a significant global impact. With its unique position as a country with rich biodiversity, a large human population, and a dynamic economic landscape, India’s approach to One Health serves as a model for other developing countries.

Furthermore, India’s collaborations with international organisations and its contributions to global health research underscore its growing influence in the global health arena. By adopting the One Health approach, India is not only striving to protect its own citizens and ecosystems but is also contributing to the broader global goal of preserving the health of our planet.

Composed by: “Varsha, proficient as a Business Analyst, has an educational foundation in healthcare IT, acquired through a PGDHM from IIHMR Delhi. Her primary interest rests at the intersection of healthcare and technology, with a specific focus on harnessing cutting-edge tech solutions to revolutionize patient care and enhance healthcare systems. Her work areas comprise optimizing healthcare data flow and improving operational efficiency, driving enhanced patient care and system robustness.”

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Boarding a wobbly roadways bus, a dhoti-kurta clad young man, with protuberant vermillion dash on forehead, used to head for mythological twin city of Mathura and Vrindavan in Uttar Pradesh, clutching tightly his voluminous bag, stuffed with Ayurvedic medicines in tiny folded paper pouches for distribution to patients at ISKON center every weekend in early nineties.

But, recently, sporting a brick colored shirt and creamy Nehru jacket and matching black tight trousers, Ayurveda medicines practitioner Dr. Partap Chauhan unveiled world’s first Artificial Intelligence (AI) powered protocols modeled on the basis of a mind-boggling database of patients and their successful cure.

Moved by the protocols’ apparent efficacy, India’s AYUSH Secretary, Dr. Vaidya Rajesh Kotecha, has minced no words for exploration of a possibility to have a link of the protocols with the Ministry’s recently floated grid for the popularization of India’s traditional medicines at international fora.

Dr. Gawande is a globally-renowned surgeon, writer, and public health innovator. He practices general and endocrine surgery at Brigham and Women’s Hospital and is a Professor at the Harvard T.H. Chan School of Public Health and Harvard Medical School.

“I’m thrilled to be named CEO of this healthcare initiative,” said Dr. Gawande, “I have devoted my public health career to building scalable solutions for better healthcare delivery that are saving lives, reducing suffering, and eliminating wasteful spending both in the US and across the world”. This work will take time but must be done. The system is broken, and better is possible.”

He is the Founding Executive Director of the health systems innovation center, Ariadne Labs. He also is a staff writer for the New Yorker magazine, has written four New York Times bestsellers: Complications, Better, The Checklist Manifesto, and Being Mortal, and has received numerous awards for his contributions to science and healthcare.

“Medicine has triumphed in modern times, transforming the dangers of childbirth, injury, and disease from harrowing to manageable. But when it comes to the inescapable realities of aging and death, what medicine can do often runs counter to what it should”. Says Dr. Gawande in his book “Being Mortal”.

Dr. Kotecha envisions Indian traditional medicines’ colossal potential in ensuring cheap and best treatment and country’s values, coupled with such medicines, have answers of all these emerging challenges. He spoke briefly about the “Being Mortal” book and the newly formed company.

The AYUSH Secretary was of the view that Indian traditional medicines should be included in ICD -11 as Chinese medicines have entered the classification already. The International Classification of Diseases (ICD) is the international “standard diagnostic tool for epidemiology, health management, and clinical purposes.” Its full official name is International Statistical Classification of Diseases and Related Health Problems and is maintained by WHO.

Amid these developments, the protocols have been framed. Dr. Partap Chauhan, Director Jiva Ayurveda, narrated his arduous journey and said India’s traditional medicines efficacy was being recognized the world over, and his protocol would help according to it a scientific explanation on various parameters.

He had started his journey from a small dispensary in a garage in Haryana in 1992, and now a globetrotter is interacting with world-famous universities for deeper scientific researches on country’s 5000 years old traditional medicines.

The personalized treatment syndrome is catching up and researchers are underway on how to promote personalized treatment for more accuracy. He said the World’s first Diagnostic Protocols for Ayurveda would turn this ancient healing tradition into a data-and evidence-driven system of medicine and JIVA Health App.

These protocols, meant to standardize the practice of Ayurveda, have taken four years to develop after analyzing the consultation records of more than two lakh patients; the protocols have been successfully run on 20,000 patients till now, with dramatic results. This system will create a wealth of data and evidence that will go on to validate Ayurveda as a legitimate science of treatment, boosting its acceptability worldwide. The JIVA health app will provide authentic and actionable health and wellness information with content exclusively curated by Dr. Partap Chauhan.

JIVA group President Rishi Pal Chauhan has said the JIVA’s unique protocols are like an operating system for Ayurveda practice that structures the practice of Ayurveda and creates the wealth of data. It is well known that unlike Allopathy, which is focused on symptoms and standardized drug choices, Ayurveda is fundamentally a personalized system of medicine.

Even though thousands of years old, this traditional system of healing, conceptually, is a far more evolved science. For instance, personalized medicine (based on genomics) and the “systems view” of human health is only now beginning to come into fashion in allopathy, when Ayurveda has been built around these very concepts.

The reason is that the scientific community asks for data and evidence – on what basis are the medicines given and how is their effect proven? This data and evidence Ayurveda does not have. The big question is: “How do you standardize a system of medicine that is fundamentally personalized, with patients being given different treatment based on the root cause, even if the symptoms are the same?”

This is the challenge of mapping intuitive Eastern systems of medicine over objective Western frameworks. Data Analysis of Consultation Records of two lakh patients four years ago, Jiva Ayurveda began a huge data analytics project, reviewing the consultation records of two lakh patients that its doctors had treated over the decades.

After analysis, running into thousands of hours using artificial intelligence, machine learning, and computer modeling, the Jiva analysts concluded that while the Ayurveda treatment cannot be standardized for every patient, Ayurveda practice can surely be standardized. In other words, the way Ayurveda practitioners diagnose patients can be standardized by laying down definite protocols. This methodology currently exists only in the mind of the Ayurveda practitioner and each arrives at the diagnosis in his own way. The result of this is that no consistent data can be generated, and the methodology cannot be validated. And so began at JIVA the painstaking process of writing diagnostic protocols around the practice of Ayurveda by scanning the consultation records of lakhs of patients.

India’s first-ever Protocols for Ayurveda: the protocols that have been created over the last four years by Jiva. These protocols, and the decision support system built over them, help Ayurveda practitioners anywhere in the world arrive at the correct diagnosis in a data-driven way. The system also categorizes the diseases in terms of severity, which has a direct bearing on prognosis. As the consultation protocol flows, based on patient answers, the system starts assigning weights to different diagnostic possibilities and makes calculations to arrive at an authoritative diagnosis. It helps avoid judgmental errors and the cost of the wrong diagnosis. It also suggests diagnostic clues that the doctor may have missed which may lead to a possible different line of treatment.

Narrating all these, Dr. Chauhan says these protocols to standardize the practice of Ayurveda, the first-ever to be attempted in India, signal a revolutionary shift. They are akin to Ayurveda’s operating system that is accessible to everybody. This system will create a wealth of data and evidence that will eventually go on to validate Ayurveda as a legitimate science of treatment, boosting its acceptability worldwide. The protocols have been run successfully on 20,000 patients so far, with dramatic results. Three international universities are collaborating with JIVA to validate this data.

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