is the text of the President, Dr. A.P.J. Abdul Kalam’s Address and interaction
with the students of Kurnool Medical College on the occasion of ITS Golden
Jubilee Kurnool :
the pain is a great Mission
professionals are in God’s mission"
I am indeed delighted to participate in the Golden Jubilee
Celebrations of Kurnool Medical College and interact with the students and
faculty members. I congratulate the Kurnool Medical College community both
present and past who have built a robust educational framework for medical
education during the last five decades. My greetings to the principal, faculty
members, doctors, nurses, para-medical personnel, support staff, medical
students and distinguished guests.
Dear Graduating students, when I see you all, in front of
me, a scene of our country appears which links the new doctors and their role in
the national mission. What is that scene? In our country, 700 million people
live in 600,000 villages equivalent to 200,000 panchayats. We have 2020 Vision
Document prepared by TIFAC, which mentions about the typical disease pattern
which will be faced by the country in 2020. It is expected that HIV/TB
combination, water borne diseases, cardiac diseases will be the predominant
diseases and we have to find solutions for diagnosing and treatment. Also there
are challenges for researchers for discovering molecule leading to drugs for
various diseases such as diabetics, cancer, allergic diseases, inflammatory
diseases, and certain type of new pattern of diseases in the tribal sector such
as sickle cell disease. Many of you may take up practising healthcare in various
fields and some of you may opt for research and development. The opportunities
for you in the country, will be challenging equally both in the urban and rural
areas. With the development of electronic connectivity and knowledge
connectivity, and the spreading of health care centres and quality education we
should be able to provide quality health care to our rural citizens. I am sure
many of you will find working in rural areas to be really challenging.
For example, tele-medicine is a new area, you may find being
used in large number of places for diagnosis and advice. Another area which is
knocking at our doors is preventive healthcare. Some of you may participate in
the research, development and use of vaccines against HIV, malaria and even
against the cardiac diseases. There are several other avenues such as
application of stem cell therapy for many ailments like treatment of heart
failure and diabetics. Students should be aware of such developments taking
place in the country and elsewhere. I have selected the topic for discussion
"Removing the pain is a great Mission."
Tradition of Research and Vision
Recently, I met Dr. Charles Cummings, of the Johns Hopkins
University Board and his team. I asked him, a question which was in my mind,
“Dr Charles, What made Johns Hopkins a world class medical research institution
in addition to its cherishing societal missions?” His answer was, “it is due to
a great tradition, and it started with a number of visionaries simultaneously
with value system, focused missions and the nature of working together. The
most important aspect is the research, research base and the quantity of
clinical data added everyday. This tradition continues even now”. Indeed it is
a great message from Dr. Charles. I am sure, every medical institution in the
country should imbibe this culture that comes out of research tradition,
leading to the results of the research reaching the people in the form of
medi-care, medicines or vaccines. I recall, in India one of the leading
institutions in Hyderabad L.V. Prasad Eye Institute has set a tradition of
providing quality eye care particularly with social commitment of 1:1. 1:1
implies one free eye care service for every paid eye care service provided by
the Institute. Also, they have a tradition of excellent research in
Ophthalmology and they are spreading the mission to various parts of the
country particularly their research in stem cell which has led to the
restoration of eye sight to 300 patients with burn affected eyes.
Health status of India
India has made considerable progress in its health status
since its Independence and particularly during the last fifteen years. At the
time of Independence, the life expectancy of an Indian was less than thirty
years. Between 1991-2006, the life expectancy of Indians has gone up from 58 to
64.35 years, infant mortality has come down from 87 to 60 deaths per 1000 live
births and population growth rate has decreased from 1.9% to 1.4%. Still infant
mortality is very high. We have to bring infant mortality to less than 1%.
I would like to briefly talk to you on some of the diseases
and actions proposed and future need. Our experiences will definitely be shared
with the third world developing nations in order to provide healthcare for all.
Drug for faster cure of tuberculosis
The entire country has been brought under the Revised
National Tuberculosis Control Programme (RNTCP). This will ensure that maximum
number of Tuberculosis cases are detected every year and brought under direct
surveillance. The treating agency must ensure that at least 80% success in
fully curing the disease is achieved within the year. If this regime is
followed continuously for over ten years our tuberculosis load will come down
to less than ten per one lakh of population. It is essential to work faster on
the development and clearance of new drugs which are in the pipeline.
Educational institutions should also participate in this mission.
India has also made significant contributions in developing drugs that are
critically required for India. One of the achievements comes from a laboratory
of the Council of Scientific and Industrial Research (CSIR). CSIR lab has
developed a new therapeutic molecule for Tuberculosis. This molecule has shown
the potential to cure TB in around 2 months, as against the standard treatment
of 6 to 8 months. This breakthrough is very important. After completing the
pre-clinical studies, the molecule transformed into a drug called Sudo-terb is
undergoing clinical trials in humans. This development has been done as a
public-private partnership involving the Lupin, the three CSIR Laboratories,
namely, Central Drug Research Institute, Indian Institute of Chemical
Technology and National Chemical Laboratory, and the University of Hyderabad.
It is hoped that the drug will be in the market soon after the clinical trials.
In addition to the above, there is also a need to develop a more effective
vaccine against tuberculosis. The combined action of surveillance, detection
and disciplined treatment have to work together to ensure faster cure of
existing cases. Prevention of future cases has to be achieved through R & D
efforts of developing new breed of vaccine and medicines. The collaborative
action is needed between healthcare personnel, academicians, doctors, researchers
and the pharmaceutical companies both in the private and public sectors to
accomplish this mission.
Incidence of Malaria has reduced from 22 lakh to 18 lakh in
the period 1998-2006. However, the death cases has increased from 644 to 943. I
understand that the conventional medicine used for treatment of Malaria namely
Chloroquin has become resistant to Falciparum which causes cerebral Malaria.
Our scientific community has developed and produced a drug named Arteether from
Artemisinin which has been found to be an effective cure for cerebral Malaria.
I understand that this drug is being exported to over forty countries. Also,
Ranbaxy has acquired a malarial drug molecule and they are progressing towards
clinical trials. The fully developed drug will be available in the market soon.
This will be another important milestone in the treatment of Malaria.
Over the years, I find that in spite of our efforts there is
no rapid reduction in the occurrence of Malaria cases in the country. While
taking up new projects, it is essential to have multi-faceted inter-sectoral
collaboration between various partners so that the impact assessment of the
project on new type of diseases can be foreseen and suitable preventive action
taken to contain the disease. In addition to this, we have to improve the
surveillance, develop rapid diagnostic kit and use the conventional prevention
methods of spraying to control the vector. International Centre for Genetic
Engineering and Bio-technology in collaboration with Bharat Bio-tech has
developed a vaccine for Malaria which will go for toxicity trials on animals.
There is a need to speed up such projects so that they will benefit the entire
community who are affected by Malaria in different parts of the world. KMC can
participate in such missions. Now, I would like to present HIV /AIDS control.
Today in our country, all age groups put together have an
incidence of 5.7 million HIV cases. 163 out of 611 districts in the country
have a high proportion of HIV cases. The scientific community had a very
important mission of determining the genetic nature of HIV that will lead to
its cure. The genetic nature when studied had some surprises. The retro virus
is RNA based and not DNA based. Most retro viruses have only three genes,
whereas the HIV virus had nine genes, with 9200 base pairs. With this
understanding of the genetic nature, a number of drugs have come in at least to
control HIV in as it is where it is condition. This intervention extends the
life of HIV affected persons. The typical drug which has been developed and
produced abroad is AZT, based on DNA synthesis. It halts the spread of the
disease. Another medicine found is INDINAVIR with equally good results. A
foreign University has tried a combination of AZT-INDINAVIR and 3TC, for some
patients, which gave unique results fully suppressing the HIV AID virus. Of
course research is continuing. I am sharing this with the young students, to
convey that there is a possibility of controlling HIV and extending the life of
patients. However, the cost of the medicine was so far prohibitive. Indian
companies have already brought down the cost of first line treatment to an AIDS
patient from 12,000 US dollars to 300 US dollars per year. Similarly, the cost
of second line treatment has also been brought down through the development of
medicines such as Viraday a substitute for Atripla from 12,000 US dollars a
month to 110 US dollars a month. Medical community assembled here should make
use of these medicines so that further cost effective methods can be evolved.
Development of Anti HIV Vaccine
Apart from the HIV control protocol, the most important
mission for the country today has to be the prevention of the spread of HIV
further. There is no other way other than developing and leading to production
an effective anti-HIV vaccine.
Phase one clinical trials of an imported Adeno-Associated
Virus based HIV vaccine was initiated at the National AIDS Research Institute,
Pune in early 2005. Thirty volunteers that were enrolled in the study and given
HIV vaccine will complete follow up in January 2007. The vaccine has been
tolerated well by volunteers and safety is good. Immunogenicity studies were
carried out during the follow up. Results will be decoded and analyzed after
follow up of the last volunteer is completed. In the event of the successful
completion of Phase-I trials, technology transfer to an Indian company will
take place. Another Phase-I vaccine trial was initiated last year at the
Tuberculosis Research Centre for the Modified Vaccinia Ankara (MVA) based
vaccine developed from the Indian HIV-1 sub type C virus genes. This vaccine
has been developed by Indian Scientists in collaboration with a US company
under the ICMR-NACO-LAVI programme. These two anti-HIV vaccines have to be
completed with a time bound mission mode, as it is very important for India’s
HIV control programme. It is also essential to take up a third fully indigenous
anti-HIV programme as a collaborative work between educational institutions
like KMC, research laboratories and traditional medicine practitioners.
Management of Cardiac Diseases
Multi-dimensional solutions are available for management of
the diseases based on my discussion with experts. The solutions include
medicinal treatment using Statins, which lowers the cholesterol in the blood by
reducing the production of cholesterol by the liver. Statins block the enzyme
in the liver responsible for making excess cholesterol. However one has to be
careful about the side effects and take adequate precautions while treating the
patients. The second is through angiography and angioplasty using stents. I
understand that very soon we may have bio-degradable stents. The next
generation stents may be nano-stents. If the heart blockage is severe, valve
defect and death of cells in the heart due to less blood supply etc. surgical
intervention will be necessary or it may lead to treatment using stem cells.
Non-invasive treatment for Coronary Artery
Today, I find that cardio vascular treatment moving towards
a totally non-invasive treatment using EXTERNAL COUNTER PULSATION (ECP), a
truly non-operative, non-pharmaceutical, safe and effective treatment which is
being used in many countries. In India also a few centres have come up. This is
a ripe area for research of the faculty members and students of KMC, Kurnool.
Human disorders can be classified into three broad
categories. They are genetic disorders, disorders due to cellular function
deficiency and disorders arising out of certain pathogens. I recommend
intensive research for developing and producing cost effective treatment regime
for the above categories of disorder through
(a) Gene therapy and gene chip research
(b) Stem cell research and
(c) Combination vaccine and pathogen specific antibiotics
This could lead to cost effective and safe treatment for the needy and improve
the quality of life of mankind on this planet. KMC can be a partner in some of
these research areas.
Recently, there was a meeting of cured patients, their
doctors and a few social workers. One important point emerged during the
interaction was that the relationship between the patient and doctor extends to
patients’ family. This in turn, transmits effective messages from one family to
another family on advice to prevent diseases, necessity of periodic checks, the
dietary habits and the need for life style changes including exercise for good
health. Actually, I believe this good contact between the doctor and patients
is very valuable. I request every doctor of KMC to play the role of a teacher
in advising every family on disease prevention and methods to lead a healthy
life. This message should also be given to all the students graduating from KMC
so that they will find time to put this noble action into practise during the
Giving quality health care through continuous acquisition of
knowledge, upgrading diagnosis and treatment, providing care and counselling
particularly to the unreached should become the life time mission of each one
of you graduating from KMC. Thus you will contribute effectively to the mission
of developed India 2020.
My greetings to all the members of KMC Kurnool during their Golden Jubilee
Celebrations and my best wishes to the students and faculty members of this
college in their mission of developing quality healthcare professionals for
May God bless you.
Five Point Oath for Medical Professionals
1. We the
medical professionals realize that we are in God’s mission.
2. We will always give part of our time for treating patients who cannot
3. We will treat at least 20 rural patients in a year at minimum cost by going
to rural areas.
4. We will encourage the development of quality indigenous equipments and
consumables by making use of them and assisting in enhancing the quality and
reliability of the products.
5. We will follow the motto "Let my brain remove the pain of the suffering
humanity and bring smiles".
Question and Answer Session
1. How can we promote the
interdisciplinary sharing of knowledge to bring out the best in the Medical
Field as far as India is concerned.
- Dr. J. Raghu, P.G. Student in M.D. (Pulmonary Medicine) , Final Year Kurnool
Medical College ,Kurnool
Ans: Hospitals need to create a culture of sharing which alone
will promote inter-disciplinary of sharing knowledge among the professionals.
To promote interdisciplinary sharing of knowledge, it is necessary to have a
common meeting of all the doctors of different specialities in the hospital. In
addition, there can be a common website in which the special cases of diagnosis
and treatment are brought out by different specialists in a hospital. This will
promote sharing of interdisciplinary knowledge. With the electronic data base
storage, all the doctors can be connected and share the knowledge about a
particular patient based on their specialization. This is also another tool by
which inter-disciplinary sharing is possible. For integrated healthcare, it
will be useful to have doctors from Allopathy, Homeopathy, Siddha, Ayurveda and
Unani in the samehospital. They can collectively examine the patients so that
the patient can get the advantage of best from all systems of medicines. Such a
scheme I have found in taking place in some parts of India.
2. May I know from you various modalities by which we can encourage youth of
India to take “Research as career option” so that India becomes a Superpower.
- S.V. Naveen Prasad, Internee, Government General Hospital, Kurnool.
Ans: I have already suggested a science cadre be created which will enable
the prospective students and their parents to appreciate the importance
research as a career. Also, there is a need for the senior scientists to
emphasize the value of science among the students right from school. Thirdly,
the students must be made to enjoy the bliss of science in small doses so that
he can get attracted to science as a life time mission.
3. May I know how we can apply advances in Technology in the field of
“Genetic Engineering “ without affecting the “morality” of the people?
- Dr. G. Hareesh Kumar, 9th semester U.G. Student, Kurnool Medical College,
Ans: When we go for high technology, we have to draw the lines through a
well defined legal framework and conventions so that we do not intrude upon
4. May I know your vision for Medical filed & recent advances in the
field of Medicine.
- Dr. K. Keerthinmayee, P.G. Student in General Surgery, Final Year, Kurnool
Medical College, Kurnool.
Ans: Some of the recent advances I have already discussed
in my talk. Stem cell research and convergence of technology(IT, Bio-technology
and nano) will play a major role in the field of medicines during the 21st
5. May I Know from your Excellency , How can advances in Nanotechnology be
made a useful tool in Medical Field.
- S. Lakshmi Sravanthi,
Internee, Govt. General Hospital, Kurnool.
Ans: Nano-technology in Drug delivery has already shown
promising result in directing the drug to the affected spot in the controlled
doses. Nano-technology can be used for cancer treatment in such a way while
destroying cancer cell, life cells are preserved. There are several uses of
this nature on which researchers in India and abroad are working.
6. Your Excellency, how the advances in Technology can be applied for the betterment
of rural health care?
- Dr. M.Swarnabala, 5th Semester, U.G. student, Kurnool Medical College,
Ans: Mobile clinics can reach the rural areas and provide health
care at the door step of the rural citizens. For higher level of healthcare tele-medicine,
tele-ophthalmology, tele-radiology are technological tools which can enable the
diagnosis and advice to reach the rural area with the help of experts located
in district and state level hospitals.
(Release ID :24502)