Department of Health Research - English - 1022
Department of Health Research - English - 1022
Department of Health Research - English - 1022
H EA L T H
Report 2020-2021
Contents
Chapter-1 Introduction 1
Chapter-5 Establishment of Model Rural Health Research Units (MRHRUs) in the states 39
Annexure BE/RE actual expenditure 2019-20 and BE/RE 2020-21 with actual 81
expenditure upto December 2020 and BE 2021-22 in respect of Demand
no.43- Department of Health Research
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Department of Health Research
1 Introduction
CHAPTER
1
Annual Report 2020-21
4. Human Resource Development (HRD) for July 15, 2019. The Lok Sabha approved the bill on
Health Research. the 5th of August 2019. The Bill defines Surrogacy
as a practice where a woman gives birth to a child
5. Grants in Aid scheme (GIA) for inter-sectoral
for an intending couple with the intention to hand
convergence & promotion and guidance on
over the child after the birth to the intending
research governance issues.
couple.
1.5 During the year under review, the
The Surrogacy (Regulation) Bill, 2019 proposes to
Department has made significant progress in
regulate surrogacy in India by establishing National
implementation of aforesaid schemes. 115 Viral
Surrogacy Board at the Central level and the State
Research & Diagnostic Laboratories (VRDLs), 80
Surrogacy Boards and Appropriate Authorities in the
Multi-Disciplinary Research Units (MRUs) and 25
MRHRUs were sanctioned up to 2020-21 (up to States and Union Territories. The major objectives
December 2020). of the Bill are to regulate surrogacy services in the
country, to provide altruistic ethical surrogacy to
1.6 Besides this, a total number of 200 the needy Indian couples, to prohibit commercial
fellowships were supported under HRD Scheme surrogacy including sale and purchase of human
during the year 2019-20 including 95 new embryo and gametes, to prevent commercialization
fellowships of 2019-20. During the year 2020-21 of surrogacy, to prohibit potential exploitation
(up to Dec 2020), a total number of ongoing 49 of surrogate mothers and protect the rights of
fellowships including fellowships of 2019-20 have children born through surrogacy.
been supported. In addition, a total number of 366
proposals have been received in response to online The Bill was placed in Rajya Sabha on the 6th of
call for proposals for the year 2020-21. November 2019 for consideration and on 21st of
November 2019 referred to the Select Committee.
1.7 A total number of 274 research projects The Select Committee report was tabled in the
were approved and funded under the GIA Scheme Rajya Sabha on the 5th of February 2020.The
upto 2019-20 including 31 new research projects of Cabinet Note pursuing the Surrogacy (Regulation)
2019-20. During the year 2020-21 (up to Dec 2020), Bill 2020 as reported by the Select Committee has
a total number of 62 research projects including been approved by the Cabinet in its meeting held
those pertaining to 2019-20 have been funded. on the 26th of February 2020 and a notice for
In addition, a total number of 1,027 proposals consideration of the Surrogacy (Regulation) Bill,
have been received in response to online call for 2020 in Rajya Sabha was issued by HFM during the
proposals for the year 2020-21 and are under monsoon session and the Bill is pending in Rajya
consideration. Sabha.
1.8 About 62 VRDLs, 47 MRUs and 11 MRHRUs
1.10 Assisted Reproductive Technology
have already initiated research activities. These
Regulation Bill ,2020
schemes are largely helping in building up a strong
and effective eco-system for carrying out health The draft Assisted Reproductive Technology
research in the country and for introduction of Regulation Bill 2017 has been framed to
new technologies, new methods of treatment and establish the National Board, the State Boards
products/processes into the public health system. and the National Registry for the Regulation and
Supervision of assisted reproductive technology
1.9 SURROGACY REGULATION BILL, 2020 clinics and the assisted reproductive technology
The Surrogacy (Regulation) Bill, 2019 was banks, for prevention of misuse and for safe and
introduced by the Hon’ble Minister of Health & ethical practice of assisted reproductive technology
Family Welfare, Dr. Harsh Vardhan in Lok Sabha on services in the Country.
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Department of Health Research
The Cabinet Note for Introduction of the Assisted (COVID-19) started spreading rapidly across the
Reproductive Technology Regulation Bill, 2020 has world in December 2019, prompting the World
been approved by the Cabinet in its meeting held Health Organization (WHO) to declare the outbreak
on the 19th of February 2020 and introduced in the as a global pandemic on March 11, 2020. The
Lok Sabha on the 14th of September 2020.The Lok Government of India mounted a swift response to
Sabha Chairman on 3rd October 2020 referred “The COVID-19 starting mid-January which continues
Assisted Reproductive Technology Regulation Bill, to be calibrated to the fast-evolving situation.
2020 as introduced and pending in Lok Sabha , to A concerted and well-coordinated Government
the Department-related Parliamentary Standing approach has been adopted to ensure a
Committee on Health and Family Welfare for comprehensive and robust response to COVID-19.
examination and report thereon within 3 months.
1.13 Preparation of Standard Treatment
1.11 Health Technology Assessment in India Workflow (STW):
(HTAIn): Simple, self-explanatory treatment algorithms for
Health Technology Assessment in India (HTAIn) is an 53 common & serious medical & surgical conditions
institutional structure, established in 2017, under have been made. These workflows comprise of
the Department of Health Research (DHR), Ministry symptoms, signs, diagnostics, treatment etc. for
of Health & Family Welfare (MoHFW) entrusted concerned diseases. A dissemination strategy is
with the responsibility to analyze evidences related being planned for putting these up in all Medical
to cost-effectiveness, clinical- effectiveness and Colleges, District Hospitals, Primary HealthCare
equity issues regarding the deployment of health centres across the country. A high-level stakeholder
technologies viz. medicines, devices and health meeting was organized in January 2020 which was
programmes by means of HTA in India, in turn attended by NITI Aayog, DoHFW, WHO, Unicef and
helping in evidence-informed decision making a few identified States.
for an efficient use of existing health resources The treatment algorithms pertain to 22 medical
and provide people affordable, accessible and and surgical specialities. Work is in progress to
quality healthcare. The main objectives of HTAIn cover a total of 122 disease conditions. The initial
is maximizing health, reducing Out of Pocket publication of 53 workflows has been hosted in
Expenditure (OOP) and minimizing inequality ICMR website for wider dissemination.
in healthcare services. It will help in developing
systems and mechanisms to assess new and existing 1.14 NLEM (National List of Essential
health technologies based on available data on Medicines):
resource use, cost, clinical effectiveness and safety. The Secretariat of the Standing National
It will also ensure healthcare accessibility and Committee on Medicines and other Health Care
usefulness to inform health policy. Dissemination Products (SNCM) is housed by the DHR. The Core
of research findings and resulting policy decisions Committee, through a series of meetings and
will educate and empower the public to make consultations with experts from across the country
better informed decisions for health. Hence, HTAIn deliberates and revises the National List of Essential
could be a useful tool in taking India towards Medicines (NLEM) from time to time. DHR provides
Universal Health Coverage. The Health Technology administrative and IT support to the SNCM.
Assessment Board Bill 2019 has been proposed to Medicines in NLEM are categorised according to
institutionalize the structure and function of the the therapeutic class and listed with doses forms
HTAIn body. and references to the levels of healthcare, namely,
1.12 Outbreak of COVID Pandemic: Primary (P), Secondary (S) and Tertiary (T).
An outbreak of the novel corona virus disease 1.15 India TB Research Consortium
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Annual Report 2020-21
India TB Research Consortium (ITRC) is a flagship This project envisages to screen 5 Lakh general
programme of Department of Health Research population from 625 pre identified clusters all
(DHR), Govt of India which was sanctioned by DHR over India excluding Andaman and Nicobar &
in December 2017 to tackle TB in a mission mode. Lakshadweep for Pulmonary Tuberculosis, using
The vision of ITRC was to accelerate development mobile medical units with inbuilt CBNAAT and
of new tools in areas of diagnostics, treatment, Chest X ray units .Confirmation of TB in suspected
vaccines and implementation research by individuals is being done by Sputum AFB and
harnessing interdisciplinary expertise and building, Sputum culture /sensitivity at state Intermediate
consolidating and strengthening scientific Reference Laboratories . The survey also intends to
capabilities by fostering in- country collaborations estimate prevalence of Latent TB infection in India
and global partnerships. using Quantiferon Gold testing (IGRA) of 41600
The first phase of ITRC was initiated in December general populations at 52 pre-identified clusters,
2017 and was successfully completed on 31st Hypertension and Diabetes Mellitus. Twenty three
March 2020. A total of 38 projects were sanctioned special teams were trained on protocol and various
and initiated in different thematic areas of research procedures of survey to execute this survey.
during the first phase of which 6 have been
Status- Total 172 clusters (155 completed and 17
completed and others are ongoing.
ongoing) are surveyed till 11th December 2020.
The significant activities of the Phase I are: Out of 172 clusters 20 clusters were paper based
survey
1. Initiation of ‘TB Vaccine trial’ in July 2019 which
is a Phase III regulatory trial for evaluating In clusters conducted on soft-ware total
the safety and efficacy of two TB vaccines population enumerated are 173714. Total no of
(VPM1002 and MIP as against Placebo) of eligible participants are 121157. Total participants
which MIP is an indigenous vaccine. The trial Interviewed are110665.Total participants
has enrolled more than 11200 participants diagnosed with pulmonary TB 408.
till date out of the target enrolment of 12000
participants. This trial is being conducted in 6 In 20 clusters where survey was conducted on paper
states and at 7 main sites. total population enumerated are 24954.Total no of
eligible participants are 20723.Total participants
2. “TrueNat”, an indigenously developed, user- interviewed are 14773 .Total participants diagnosed
friendly, cost-effective & sensitive diagnostic with pulmonary TB78.
tool for TB diagnosis was taken up by ITRC for
feasibility studies in India and also for Global 1.16 NATIONAL ETHICS COMMITTEE REGISTRY
study coordinated by FIND. The TrueNat has FOR BIOMEDICAL AND HEALTH RESEARCH
been adopted by National TB Elimination (NECRBHR)
Programme (NTEP) for use under National The Ministry of Health and Family Welfare,
programme and WHO has also recommended Government of India, had notified the 'New Drugs
its use for TB and MDR-TB after the Global and Clinical Trials Rules, 2019', which came into
study results were presented to WHO. force from the 19th March, 2019. As stipulated in
National TB Prevalence Survey Chapter IV of these Rules, which came into force
after 180 days, Ethics Committees (ECs), reviewing
The ongoing project National TB Prevalence (NTBP)
biomedical and health research, involving human
survey, funded by Central TB Division, Mo-HFW and
participants, shall register with the authority
supported by WHO, UNAIDS being conducted by
designated by the Central Government in the
DHR/ICMR was inaugurated by Dr Harsha Vardhan
Ministry of Health and Family Welfare, Department
,Hon’ble Minister for Health and Family welfare on
of Health Research (DHR). Accordingly, National
25th September 2020 .
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Department of Health Research
Ethics Committee Registry for Biomedical and put in place for registration of ECs and conferences
Health Research (NECRBHR) had been set up in DHR and training programmes in association with the
in September, 2019. For this purpose, a software, Indian Council of Medical Research.
namely, 'Naitik portal' (https://naitik.gov.in/), has
also been developed and launched for online 3. After this registry started functioning, requests
submission, receipt and processing of applications for registration of ECs were received, and are being
received, from various organizations through
for EC registration. This is expected to bring out the
much-needed transparency, accountability and the said portal. More than 1019 login requests
organizational structure in the area of biomedical and 630 EC registration applications have been
and health research, involving human participants. received till December 2020. Against it, 401 ECs
have been issued Provisional Certificate during
2. Outreach measures for disseminating the the corresponding period, which includes more
requirements and necessity for registration of ECs than 104 Government institutions, 26 Universities
were extended through issue of notifications to and around 153 medical colleges (Private/Govt).
various stakeholders and nodal agencies under the Information of all these ECs are in public domain
Government for wide publicity of the arrangement on the Naitik portal.
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Annual Report 2020-21
Hon'ble Home Minister Shri Amit Shah inaugurating the mobile COVID-19 RT-PCR Lab jointly developed
by ICMR & SpiceHealth that will revolutionize Covid-19 testing in India
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Department of Health Research
Dr. Harsh Vardhan, Hon'ble Union Minister for Health & Family Welfare has released a book on
"100 years History of ICMR-NIN"
Secretary, DHR addressing the audience on the occasion of National Constitution Day at ICMR HQ
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Annual Report 2020-21
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Department of Health Research
2.1 The Department of Health Research has Research Consortium, Ethics Committee, response
formulated five Central Sector Schemes for to the outbreak of Covid-19 pandemic. Further,
implementation across the country. Over the years, the Indian Council of Medical Research (ICMR) is
additional responsibilities have been entrusted administered by DHR. Presently, DHR has a total
to the Department which include HTAIn, National of 42 sanctioned posts in different grades with
List of essential Medicines (NLEM), Preparation incumbency position as under:
of Standard Treatment Workflow (STW), India T.B.
Table (1)
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Annual Report 2020-21
2.2 The process of filling up of the vacant posts is this is a suspended as per GOI
under consideration in consultation with the instructions to contain spread of Covid
concerned Departments/ Cadre Controlling 19 pandemic.
Authorities. Recruitment Rules for the posts
c. Official e-mail IDs of all staff members
of Scientists are under consideration in
have been created under the
consultation with the UPSC. Thereafter, these
Government of India e-mail services and
posts will also be filled up.
is used for all official communication.
2.3 Grievance Redressal Mechanism: The
d. All computer systems have Local
Department has Grievance Redressal
Area Network (LAN) connectivity
Mechanism with the Deputy Secretary as
through NIC and leased line circuits to
nodal officer.
facilitate speedy implementation of
2.4 Complaints Committee for Prevention e-Governance Policy of Government.
of Sexual Harassment of Women at Work
e. Government e-Marketplace (GeM) is a
Places: Department has setup a Complaint
paperless, cashless and system driven e-
Redressal Mechanism to look into the
market place that enables procurement
matters/cases of sexual harassment of female
of common use goods and services
employees of the Department.
with minimal human interface. As per
2.5 E-Governance Initiatives: In order to the latest General Financial Rules of
promote and strengthen ICT enabled e- Government of India, the Department
Governance in the country, Department of of Health Research uses GeM for
Health Research has taken several initiatives procurement of common use goods
to digitize certain activities, in the following and services in a transparent, efficient
manner: and cost-effective manner. During
2020-21 (till date), the procurement
a) The Department has been using
through GeM was above 95% of the
the e-Office software, designed and
overall procurement of Goods and
developed by the National Informatics
Services by the Department.
Centre, for online processing of
receipts and files. As per Government f. In the present Covid-19 pandemic
of India directive, e-filing system is situation, meetings and conferences are
to be implemented in Ministries/ arranged on virtual basis by following
Departments for a more effective and Standard Operating Procedures (SOPs)
transparent inter and intra-government of M/o Home Affairs and M/o Health &
processes. Family Welfare.
b) The staff of DHR mark their attendance g. For initiating online application and
digitally through AADHAR based maintaining of DHR Schemes, an
Biometric Attendance System. It e-Project Performance Management
enables monitoring of attendance System (e-PPMS) portal has been
and generation of reports through the developed which is very useful for
website attendance.gov.in designed smooth functioning and monitoring of
and hosted by NIC. However, presently all schemes of DHR.
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Department of Health Research
FINANCE:
Allocations and Expenditure from 2015-16 to 2019-20 (14th Finance Commission period) and for 2019-20,
2020-21 and 2021-22 are as follows:
(Rs. in Crores)
Year BE RE Actual Expenditure
2015-16 1018.17 1012.51 992.77
2016-17 1144.80 1344.80 1323.60
2017-18 1500.00 1743.39 1731.68
2018-19 1800.00 1742.73 1727.87
2019-20 1900.00 1950.00 1934.03
Total (14th Finance 7362.97 7793.43 7709.95
Commission period)
2020-21 2100.00 4062.30 2716.45*
(expenditure upto 31st
December, 2020)
2020-21 - - 1345.85
(estimated expenditure
for January–March 2021)
2021-22 2663.00
A statement indicating the scheme-wise BE/RE/actual expenditure for 2019-20 and BE/RE for 2020-21 with
actual expenditure upto 31st December, 2020 and BE 2021-22 in respect of Demand No.43-Department
of Health Research is given at Annexure.
Audit Observations:
There was no C&AG Audit Para pertaining to the Department of Health Research (DHR) during the year.
The position of PAC/C&AG Audit Paras pertaining to the Indian Council of Medical Research is as
follows:
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Annual Report 2020-21
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Schemes of Department of
Health Research (DHR)
Annual Report 2020-21
During the past few years, India has witnessed augmenting the quality parameters for consistent,
several outbreaks of emerging/ re-emerging reliable and high-quality diagnosis; initiated event-
viral infections. Annual epidemics of Dengue, based surveillance for fast detection of outbreaks;
Chikungunya, Influenza, Rotavirus, Measles Rubella, strengthened coordination of VRDLs with the
Japanese encephalitis etc. are reported from State Public Health System, Integrated Disease
all parts of the country. Besides, in the past two Surveillance Program (IDSP) and National Vector
decades, India has witnessed acute outbreaks or Borne Disease Control Program (NVBDCP); initiated
threats of infiltration of new or exotic viruses such structured research projects which would translate
as Nipah virus (2001; 2007; 2018 & 2019); SARS-CoV into information for drafting/refining public health
(2003); Avian Influenza H5N1 (2006); ECSA strain of policies. Some of the key contributions of VRDLs in
chikungunya (2006); pandemic influenza (2009); maintaining disease security is as below:
Zika virus (2016). Ebola, Yellow fever and MERS-CoV
(Middle East Respiratory Syndrome-coronavirus) Sentinel surveillance for Zika viruses (ZIKV)
are the other potential viral agents which pose a has been established through 35 VRDLs.
serious threat to the country. Six VRDLs have been trained at NIV, Pune and
2. Realizing the high risk faced by the country are equipped with diagnostic capacity for
due to emerging/re-emerging viral infections Yellow Fever.
and limited capacity for timely detection of such A significant achievement has been that
viruses, the Department of Health Research (DHR)/ 30 VRDLs are contributing to Influenza
Indian Council of Medical Research (ICMR) took a surveillance (both type and subtype of
far-sighted decision of enhancing the country’s influenza) in the country and data, through
capacity for early identification and diagnosis of NIV, is being fed into WHO Flunet database.
all viral infections of public health importance.
This initiative of DHR/ICMR has been rolled out on Integration of six VRDLs into WHO MR Labnet
approval of the VRDL Scheme by the Union Cabinet. and Six VRDLs have been involved in WHO-MR
Labnet to conduct case based surveillance for
3. Viral Research & Diagnostic Laboratories (VRDLs) Measles and Rubella, in line with India’s target
played a significant role in surveillance, diagnosis of measles elimination and Rubella control by
and detection of outbreaks. The Scheme is in the
2023. Inclusion of VRDLs are in the pipeline
mid phase for setting up of new VRDLs and creating
and nine more VRDLs are in pipeline, who
high quality systems for existing network which
have completed the phase II and entering in
has significant role in identification of emerging/
phase III.
re-emerging viral pathogens at an early stage and
preventing spreading of epidemics. The network Thirty VRDLs are involved in diagnosis of
of VRDLs is now working in synchronized way by non-viral etiologies – Scrub Typhus and
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Department of Health Research
Leptospirosis, of acute febrile illness. This has been trained on techniques and assays for
broadened the scope of VRDLs beyond viral diagnosing various virus etiologies (including
diseases but still taking care of diseases that SARS-CoV-2, Zika Virus, and Yellow Fever
are important from public health point of diagnostics) and biosafety and biosecurity
view. parameters.
Scientists from nine VRDLs have been Turnaround time reduced from 7 days to 24-
given hands-on training by ICMR-NIV, Pune 48 hours.
on handling emerging/re-emerging viral
infections such as Influenza, Nipah, Ebola Research activities: Following multicentric
etc. This would serve as a stepping stone studies / activities are undergoing:
towards creating capacity for a countrywide Influenza: Assessment of
biosecurity platform. Neuraminidase Inhibitor Susceptibility
A sizeable number of VRDLs have been able in influenza A(H1N1) pdm09 viruses.
to establish robust linkages with State IDSP, Dengue: Monitoring of Dengue and
NVBDCP and State public health departments,
Chikungunya viruses circulating in India
thus increasing outreach of public health
for changes in the serotypes, genotype
programs.
and lineages utilizing Viral Research &
During the year 2020, VRDLs were actively Diagnostic Laboratories Network
involved in COVID-19 testing, this impacted
Standard Operating procedures: A generic
the routine diagnosis of other viral agents of
SOP for molecular testing of Influenza
public health importance. Due to which no.
suspected samples has been written and
of tests conducted by the VRDLs were very
vetted by experts. This will be disseminated
less as compared to previous years. A total
to all the VRDLs so that labs develop their
of 105 VRDLs are currently diagnosing 15-35
viral etiology. Testing data are being fed into own SOP to have some uniformity of the
the Data Mining Centre at National Institute test procedure. Similar exercise for Flavivirus
of Epidemiology (NIE). Total test reported detection is underway.
to the NIE portal during the year 2020 was Advocacy workshop: A Regional Advocacy
152575. A total of 6 outbreaks were actively Workshop was jointly organized by
investigated by the VRDL network during Department of Health Research (DHR),
January-October 2020. The major etiological Ministry of Health & Family Welfare,
agents of the investigated outbreak are Government of India, New Delhi and ICMR-
(Dengue, Measles, Varicella Zoster virus, Rajendra Medical Research Institute for
Hepatitis E and Influenza H1N1.
Medical Sciences, Patna on 17th January
Organizing training for Data Entry at NIE 2020 at RMRIMS campus. In this workshop
Chennai and Technical Training on Viral six Viral Research and Diagnosis Laboratories
Diagnosis at NIV Pune could not happen due (VRDLs) from Bihar and Jharkhand State have
to COVID-19 pandemic. However, several participated. Besides, representatives from
virtual training sessions have been conducted WHO, NCDC-IDSP, NVBDCP and State health
for VRDL staff. Technicians plus Scientists have authorities have participated.
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Annual Report 2020-21
Physical Target
12th Plan Period (2012-2017)
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Department of Health Research
The List of Institute for establishment of 10 Regional Role of VRDL Network in COVID-19
Labs is given at Annexure-I. A decade ago, when India witnessed one of the
The State-wise list of VRDLs is given at Annexure-II. worst flu pandemic, swine flu in 2009, the public
health system was paralyzed due to severe dearth
Components of the Scheme and Funding Norms: of infrastructure for molecular diagnosis of viral
infections and the public health professionals
1. Regional Labs*: The non-recurring cost of a
helplessly watched the pandemic quickly escalating
Regional Level Lab would be Rs.14.95 crore for
to all parts of the country. Though the country was
development of infrastructure, which include civil
equipped to carry out serology-based ELISA or
works (Rs.4.20 crore), furnishing and furniture
rapid blood tests, but the virus was challenging and
(Rs.50 lakh) and equipment (Rs.10.25 crore). The
could not be detected in blood. Similar challenge
recurring cost of Regional Lab per annum is Rs 1.25
is posed by several other respiratory viruses, MERS-
crore, towards staffing (Rs.90 lakh), consumables,
CoV, SARS-CoV and SARS-CoV-2 causing COVID19
contingencies and training (Rs.35 lakh).
which pose a threat to us time and again.
2. State Level Labs#: The non-recurring cost
Molecular virological test was the only option for
of a State Level Lab would be Rs.3.975 crore for
detection of H1N1 which was there in only two
development of infrastructure which include civil
Institutions: ICMR-National Institute of Virology
works mainly for renovation/modification of the
at Pune and National Centre for Disease Control
building (Rs.50.00 lakh) and for equipment (Rs.3.475
in Delhi in a vast country like India. The event
crore). The recurring cost of a State Level Lab per
was an eye-opener for the public health system
annum is Rs.63.00 lakh which will be extended for a
of the country wherein glaring gaps in capacity
period of five years for engaging trained technical
were brought out. This in turn paved the way for
manpower on contractual basis (Rs. 38.00 lakh per
strengthening the molecular diagnostic facilities
annum) and for consumables, contingencies and
for viruses in India through the Virus Research
training (Rs.25.00 lakh).
& Diagnostic Laboratory (VRDL) Network of
3. Medical College Labs #: The non-recurring cost DHR. Contrary to 2009, in January 2020, when
of a Medical College Level Lab would be Rs.1.439 the threat of COVID19 epidemic knocked our
crore comprising of Rs.93.90 lakh for equipment and doors, the country could immediately scale up its
Rs.50.00 Lakh for civil works /renovation of building. preparedness by standardizing diagnostic assays
The recurring cost of a Medical College Level Lab at ICMR- National Institute of Virology in Pune and
per annum is Rs.39.00 lakh, towards staffing (Rs.24 immediately commissioning diagnostic facility in
lakh) and consumables, contingencies and training 13 DHR-VRDLs based on their location in cities with
(Rs.15 lakh). International airports.
*All the Regional Labs will be managed and fully The first case of COVID-19 in India was
funded by the Department of Health Research. detected by the one of State level VRDL
laboratory NIV Field unit, Alapuzhha (Kerala)
#However, the cost towards establishment of and confirmed by ICMR-National Institute of
State Level Labs and Medical College Labs, will Virology, Pune.
be shared between the Central Government and
the concerned State Government in the ratio In order to quickly enable resources for
of 75:25. For north- eastern states, hilly states, testing of suspected cases of SARS-CoV-2,
including Sikkim and J&K, the ratio would be network of 115 Virus Research and Diagnostic
90:10. The cost of land/building to be provided Laboratories (VRDLs) has been mobilized
by the State Governments will be reckoned for the preparedness against the COVID-19
towards its contribution. outbreak.
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Annual Report 2020-21
The NIV Pune being the apex laboratory for QA/QC Activity for COVID-19 Labs: India has
viral research served the role of resource expanded COVID-19 testing laboratories with
center for the VRDL network for technical different testing platforms in a phased manner.
guidance in testing, and had conducted In order to control the errors in performance of
optimization study on various testing assays testing and to have a reliable test result, a system of
Inter Laboratory Quality Control (ILQC) have been
targeting different genomic regions of SARS-
enabled with the help of VRDL Network. The labs
CoV-2.
participate in this activity on quarterly basis. ILQC
As on date, all 115 VRDLs are functional and of the labs is implemented through a three-tier
are involved in COVID-19 testing. Results are structure.
being reported to ICMR Data Portal. National QC Lab
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Annual Report 2020-21
Annexure I
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Department of Health Research
Annexure II
State wise list of VRDLs
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Annual Report 2020-21
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Department of Health Research
Madhya Regional Level 56 All India Institute of Medical Sciences, Bhopal, 2014-2015
Pradesh Madhya Pradesh
Medical College Level 59 Gajra Raja Medical College, Gwalior, Madhya 2016-2017
Pradesh
Medical College Level 61 Shyam Shah Medical College, Rewa, Madhya 2017-2018
Pradesh
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Annual Report 2020-21
Medical College Level 64 G.S Seth Medical college and KEM Hospital 2018-2019
Meghalaya State Level 73 North Eastern Indira Gandhi Regional Institute 2013-2014
of Health and Medical Sciences (NEIGRIHMS),
Shillong
Medical College Level 78 Indira Gandhi Medical College & Research 2016-2017
Institute, Puducherry
Medical College Level 81 Guru Gobind Singh Medical College, Faridkot 2020-2021
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Annual Report 2020-21
Uttarakhand State Level 105 All India Institute of Medical Sciences (AIIMS) 2019-2020
Rishikesh
Medical College Level 107 Govt. Medical College, Haldwani, Uttarakhand 2015-2016
West Bengal Regional Level 108 ICMR Virus Unit, National Institute of Cholera & 2014-2015
Enteric Diseases, Kolkata
Medical College Level 110 Institute of Post Graduate Medical Education & 2015-2016
Research (IPGMER), Kolkata
Medical College Level 112 Midnapore Medical College, Midnapore, West 2016-2017
Bengal
Medical College Level 114 North Bengal Medical College, Darjeeling 2016-2017
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Department of Health Research
4 ESTABLISHMENT OF MULTI-DISCIPLINARY
RESEARCH UNITS (MRUs) IN STATE GOVERNMENT
CHAPTER
MEDICAL COLLEGES/RESEARCH INSTITUTIONS
4.1 Health Research is predominantly carried Medical Colleges have not been pursuing newer
out in the Medical Colleges/Institutions providing methods of investigation for understanding the
education in allied subjects. Medical Colleges are pathological diagnosis, treatment and management
the backbone of both teaching and providing practices. Even for State Governments, Health
specialized services to patients in India. They are also Research has not been perceived as a priority area.
expected to set the trends in the thinking process This has also affected the quality of clinical services
and innovations to improve the understanding being provided.
of the diseases and their management. However,
4.3 Therefore to promote and encourage
over the years it has been noticed that the majority
quality medical research in the country and
of Medical Colleges have confined themselves
provide assistance to medical colleges to set up
to routine patient care and teaching based on
appropriate research facilities, the Department of
conventional methods. Presently quality medical
Health Research rolled out the MRU scheme in the
research is largely confined to a handful of
year 2013-14 during 12th five year plan and was
institutions and medical colleges in the country,
extended for the 14th Finance Commission Period
that too in few States only. The standard of papers
i.e. 2017-18 to 2019-20 with total estimated cost of
published / research projects undertaken by the
the project of Rs. 394.86 Crores. The Government
students of Post-graduate courses/PhD in most
has further extended the scheme for 2020-21.
of the Medical Colleges are not inspiring. The
Department observed that it may be attributed 4.4 The scheme aims to provide infrastructural
both to lack of appropriate facilities for conducting support, in terms of civil works, equipment and
research and a lack of motivation and knowledge recurring expenditure, to carry out research
on the part of faculty and students in Medical focused on non-communicable diseases, to various
Colleges for conducting research. State Govt. Medical Colleges across the country in
phased manner.
4.2 Due to lack of infrastructural facilities, the
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Annual Report 2020-21
4.5 The scheme entailed setting up of 90 MRUs in the Government Medical Colleges/ Research
Institutions till the 14th Finance Commission Period. However, 80 MRUs have been approved till
December, 2020 and admissible grant to 79 MRUs has been released.
Financial Achievements:
(Rs in Crore)
2020-2021 - - 18.57
(estimated
expenditure for
January-March 2021)
Physical Achievement
Year *Target as per SFC Approved against target
2013-14 35 36
2014-15 45 25
2015-16 - 9
2016-17 - -
2017-18 12 4
2018-19 10 5
2019-20 10 1
2020-21 10 **06
*Target includes spill overs from previous years
** 06 Proposals in pipeline
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Annual Report 2020-21
ii. Since each Medical College has constituted its own local Research Advisory Committee (RAC), which
decides research projects under MRU, the role of DHR & ICMR is limited to providing handholding
to the medical colleges on designing research proposals, monitoring of progress of the research
activities and achievement or outcomes. For this purpose, a National Level Research Advisory
Committee (NAC) consisting of three expert members has been constituted for making suggestion
and providing guidance from time to time. A suggestive structure/composition of the Local RAC has
also been conveyed to the medical colleges for effective & qualitative examination and approval of
research proposals.
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COVID
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Department of Health Research
5.1 Public health system in India has a wide operator (Centre/State Health services) and the
network of primary centres at the periphery, plus beneficiaries (community).
referral, secondary and tertiary level hospitals
at district, state and other levels. Over the last 5.4 The Model Rural Health Research Units set
more than 60 years, preventive, diagnostic and up under the Scheme undertake the following
therapeutic services have been provided through functions:
this network managed by States. It has been i. Develop state / area specific models
observed that a big gap exists between PHC/ depending upon the disease profile, morbidity
CHC and tertiary care hospitals with state-of-art- patterns and local conditions for transfer of
facilities created by centre and also by some of the the technology for providing better health
state governments. The professional and policy care services to the rural masses.
makers have a general view that modern methods
of diagnosis and management cannot be practiced ii. Training the health professional of State Health
a peripheral level. System for the use of modern field adaptable
methods and the model developed.
5.2 Further, wide variations exist in the pattern of
diseases prevalent in different geographical areas, iii. Undertake various research projects in closed
the local conditions which require development coordination with the State Government
of state/area specific disease; specific strategy to institutions and others that are relevant and
provide better health care facilities ensuring that beneficial to the rural population.
the modern technology is available to the general iv. The Units will develop State specific models
public. Transfer of research findings/technologies depending on the disease profile, topography
at the rural level has been found to be major lacuna and the local conditions as per the priorities &
for providing quality medical services to the rural location identified by the State Govt. in close
population. coordination with State Health Authorities.
5.3 To bridge the gap, Department of Health 5.5 The MRHRU will be an interface between
Research has rolled out a Scheme for ‘Establishment patient, health providers and health researcher
Model Rural Health Research Units (MRHRUs) in to provide latest / sophisticated technology for
the States’ under the initiative of Infrastructure diagnosis and management of disease in rural
Development for Health Research in the country. The areas. The activity will be entirely supported by DHR
scheme is based on the experience of establishing for its sustenance. In total, 25 MRHRUs are to be
such a unit at Ghatampur under the National established during the 14th Finance Commission
Jalma Institute of Leprosy and other Mycobacterial period. Each MRHRU has to be linked to the nearest
Diseases (ICMR), Agra, where the methods of ICMR institute to mentor and guide the research
diagnosis and treatment as well as epidemiology activities of MRHRU relevant to local needs. The
are shown to be workable deep at the grass root research activities carried out at each MRHRU are
rural settings. These units have been envisaged to monitored/guided by a Committee, consisting
function as an interface between the developers of of eminent Scientists of National repute with
new technologies (Researchers in the medical and representation from State Govt. Medical Colleges,
other institution; State or Centre), health systems
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Annual Report 2020-21
State Health Services and other concerned State in close proximity to the PHC/CHC, free of cost, to
Health Officials, constituted with the approval of tackle mainly the rural population of that area.
Secretary, DHR. Total estimated cost of the project
for 14th Finance Commission Period is 105 Crore. 5.8 Signing of MoA with the Department
The scheme has been extended for 2020-21 also. of Health Research for implementation of the
program. The MRHRUs will be developed and
FUNDING NORMS AS APPROVED BY THE SFC maintained as departmental units of Government
FOR EXTENDED PERIOD OF THE SCHEME: of India, Department of Health Research, Ministry
5.6 Rs. 3.075 crore per MRHRU towards of Health & Family Welfare.
Equipment & Civil works. Besides, recurring Status of Implementation
expenditure of Rs. 84.44 lakhs per annum towards
staffing on contractual basis and consumables/ 5.9 Till December 2020, 25 MRHRUs have been
contingency/training etc. approved and funds released .
Action Expected from the State Governments: 5.10 Against the Provision of Rs. 16.00 crores
in 2020-2021, grant of Rs. 6.05 crores has been
5.7 To provide requisite land sufficient to released till December, 2020.
construct covered space of about 620 sq. meters
Physical Target and Financial Achievement for the 14th Finance Commission Period.
5.11. Physical Achievements:
Year Physical
Target* Achievement
2013-2014 7 8
2014-2015 8 4
2015-2016 - -
2016-2017 - 2
2017-2018 5 -
2018-2019 4 4
2019-2020 4 7
2020-2021 5 -
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Department of Health Research
S.No State Location of MRHRU Linked Medical College ICMR Mentor Institute
1 Assam PHC Chabua Assam Medical College, Dibrugargh RMRC, Dibrugargh
2 Himachal CHC, Haroli, Una Dr. RPGMC, Tanda, Kangra NJIL&OMD, Agra
Pradesh
3 Tamil Nadu State Rural Health Centre at Tirunelveli Medical College, NIE, Chennai
Tirunelveli Tirunelveli
4 Tripura Kherengbar Hospital, Agartala Medical College, Agartala RMRC, Dibrugargh
Khumulwng
5 Rajasthan Bhanpur Kalan, Govt. Health SMS Medical College, Jaipur DMRC, Jodhpur
Clinic, Jaipur
6 Maharashtra Sub District Hospital, Grants Medical College and JJ Group NIRRH, Mumbai
Dahanu, Thane of Hospital, Mumbai
7 Punjab CHC Bhunga, Hoshiarpur Govt. Medical College, Amritsar NIOP, New Delhi
8 Karnataka PHC, Sirwar, ManviTaluk, Raichur Instt. of Medical Sciences, RMRC, Belgaum
Raichur Raichur
9 Andhra Old RHTC Premises, S.V. Medical College, Tirupati NIN, Hyderabad
Pradesh Chandragiri
10 Odisha Block, CHC, Tigiria SCB Medical Collge, Cuttak RMRC, Bhubaneshwar
11 Madhya PHC Badoni, Datia GR Medical College, Gwalior RMRCT, Jabalpur
Pradesh
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Annual Report 2020-21
S.No State Location of MRHRU Linked Medical College ICMR Mentor Institute
12 Chhattisgarh CHC Jheet, Patan Block, J.N.M. Medical College, Raipur NIRTH, Jabalpur
Durg District
13 West Bengal North Bengal Medical North Bengal Medical College, National Institute of Cholera
College (NBMC), Darjeeling Darjeeling and Enteric Diseases (NICED),
(A rural hospital and Kolkata
designated Rural Health
Training Centre)
14 Jharkhand Angara CHC, Ranchi Rajendra Institute of Medical NIMR, New Delhi AND NIMR
Sciences (RIMS), Ranchi field unit Itki, Ranchi
15 Gujarat RHTC Surat GMC, Surat NIOH, Ahemedabad
16 Kerala CHC, Chettikade, Alappuzha Govt. Medical College, Alappuzha National Centre for Disease
Informatics and Research
(NCDIR), Bangalore
17 Jammu & PHC Khag, Budgam Govt. medical College, Srinagar National Institute of
Kashmir Pathology (NIOP), Delhi
18 Nagaland PHC Niuland, Dimapur There is no medical College, so CHC Regional Medical Research
Niuland will be the linked to MRHRU Centre, Dibrugarh, Assam
19 Arunachal CHC Sagalee, Papumpare TomoRiba Institute of Health Regional Medical Research
Pradesh & Medical Sciences (TRIHMS), Centre, Dibrugarh, Assam
Neharlagun
20 Meghalaya Sohra CHC East KhasiHills District Surveillance (IDSP), East Khasi Regional Medical Research
Hills Centre, Dibrugarh, Assam
21 Puducherry CHC Kanchepuram Pondicherry Institute of Medical VCRC, Puducherry
Sciences Rural Health Training Centre
Chunampet Kanchipuram
22 Haryana CHC, Khatpura Kalapana Chawla Govt. Medical NICPR, Noida
College, Karnal, Haryana
23 Andaman Chouldari, South Andaman ANIMS, Port Blair Regional Medical Research
& Nicobar District Center, Port Blair
Islands
24 Bihar PHC, Kudhani Muzzafarpur Sree Krishna College and Hospital, Rajendra Memorial Research
Muzzafarpur Institute of Medical
Sciences(ICMR), Patna
25 Telangana PHC Janampet, Govt. Medical College, National Institute of
Mahaboobnagar Mahabubnagar Nutrition, Hyderabad
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Annual Report 2020-21
Initiation of research activities by the MRHRUs: 8. PHC, Sirwar, Manvi Taluk, Raichur, 34
5.13 Guidelines have been formulated for Karnataka
composition of Research Advisory Committee 9. PHC Badoni, Datia, Madhya Pradesh 2
(RAC), Terms of Reference and Procedure for 10. Block, CHC, Tigiria, Orissa 21
Land Transfer by State to Department of Health 11. CHC, Haroli, Una, Himachal Pradesh 17
Research. All MRHRUs have constituted the RAC and Total 204
submitted the research proposals after approval
5.15. Besides the above mentioned research
through respective RAC.
projects undertaken by individual MRHRUs,
5.14 All the research projects submitted by these Few Multi-centric projects have also been
MRHRUS have been reviewed by Research Advisory initiated.
Committee of respective MRHRU as below:
i. “Improving health and nutritional status
Table of vulnerable segment of population by
S.No. Name of MRHRUs No. of implementing multi-component health
Projects and nutrition education intervention as
1. Sub District Hospital, Dahanu, Thane, 19 sustainable model of intervention” has been
Maharashtra initiated at Rajasthan, Tamil Nadu, Punjab,
2. State Rural Health Centre at Tirunelveli, 36 Maharashtra and Karnataka MRHRUs.
Tamil Nadu
3. Old RHTC Premises, Chandragiri, Andhra 26 ii. The study has also been initiated in some
Pradesh MRHRUs titled “Snake Venom as Potential
4. CHC Bhunga, Hoshiarpur, Punjab 20 Inflammation Inhibitor and Antivenome
5. Kherengbar Hospital, Khumulwng, 11 Activity of plant extract”, considering this as
Tripura a widespread problem in most of the rural
6. PHC Chabua, Assam 14 areas in the country.
7. Bhanpur Kalan, Govt. Health Clinic, Jaipur, 4
Rajasthan
New building of Model Rural Health Research Unit, Dahanu, Palghar, Maharashtra
44
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Annual Report 2020-21
46
Department of Health Research
( Rs. in Crore)
Year Physical Targets Grand Total
(including committed
No. of projects liabilities + administrative
expenses)
2017-18 41 101.86
2018-19 41 99.36
2019-20 41 95.86
2020-21* SFC Period extended upto 31.03.2021
Total 123 297.08
* The process of screening and shortlisting of 1,027 proposals received during call for proposals for the current
financial year 2020-21, has been initiated. At this stage, it is not possible to mention the number of projects
sanctioned upto December 2020 and estimates for January - March 2021 separately.
6.3: The Scheme has the following components duration of 3 years and cost range between Rs.50
for funding: lakhs-Rs.3 crores each, were targeted to be funded
(i) Research studies with emphasis on public under this category at a total estimated cost of
health: Rs.135.00 crores during 14th Finance Commission
period (i.e.) 2017-2018 to 2019-2020 and extended
The objective of this component is to support upto 31st March 2021.
research studies on diseases burden, risk factors,
diagnosis & treatment, etc. of major diseases. The (ii) Translational Research Projects:
studies are limited to Non-Communicable Diseases. The objective of this component is to translate
A total number of 63 studies, with the maximum the already identified leads into products and
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Annual Report 2020-21
processes in the area of human healthcare, through 1-3 years per project were targeted to be funded
coordination among the agencies involved in basic, under this category at a total estimated cost of
clinical and operational research for use in the Rs.45.00 crores during 14th Finance Commission
public health system. It is proposed to take up 75 period (i.e.) 2017-2018 to 2019-2020 and extended
leads already available with ICMR, 25 leads from upto 31st March 2021.
Extramural projects funded by ICMR and 15 leads
from other Science & Technology Departments/ (iv) Cost effectiveness analysis of health
Organizations. A total Number of 30 projects with technologies through a health technology
a duration of 1-3 years and cost range of Rs. 50 assessment system
lakhs-10 crores were targeted to be funded under The aim of the studies would be to come up with
this category at a total estimated cost of Rs.90.00 appropriate recommendations and guidelines
crores during 14th Finance Commission and on cost effective but viable technology/process/
extended upto 31st March 2021. diagnostics for managing various disease, to
(iii) Inter-sectoral Co-ordination including facilitate public choice and controlling health care
Funding of Joint Projects costs, while maximizing health outcomes. A total
number of 15 projects with a cost range of Rs.50
The objective of this component is to promote joint/ lakhs-Rs.2 crores and duration of 1-3 years were
collaborative research projects with other agencies targeted to be funded under this category at a
involved in bio-medical-health research in the total estimated cost of Rs.15.00 crores during 14th
country for optimum use of resources and transfer Finance Commission period (i.e.) 2017-2018 to
of knowledge. A total number of 15 projects with a 2019-2020 and extended upto 31st March 2021.
cost range of Rs.50 lakhs-10 crores and duration of
2020-21 - - 15.46
(estimated expenditure (approx.)
for January-March 2021)
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Department of Health Research
Physical Achievement:
Components of the Scheme No. of Projects Sanctioned
2015-16 2016-17 2017-18 2018-19 2019-20 2020-21
Note: Both the NGOs are registered on the Niti Aayog's DARPAN Portal.
6.6 Grant-in-aid Scheme for Inter-Sectoral Convergence & Coordination for Promotion and Guidance on
Health Research in North Eastern states:
(Rs. in Lakhs)
2017-18 2018-19 2019-20 2020-21 2020-21
(Expenditure upto (estimated expenditure
31.12.2020) for January-March 2021)
32.91 12.93 0 0 9.99
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Annual Report 2020-21
50
Department of Health Research
7.1 Introduction (about the scheme and its age of 45 years. A stipend of $3000 per month
objectives) for foreign institute and Rs 40,000 per month for
The Human Resource Development Scheme of Indian institute is being given to the fellows. This
Department of Health Research is intended to component has also been transferred to the ICMR
create a pool of talented health research personnel for implementation. However, during 2020-21,
in the country by upgrading skills of faculty of fellowships for training in Institutes abroad have
Medical Colleges/Institutes, mid - career Scientists, been kept on hold due to Covid-19 Pandemic
medical students, etc., by specialized training across the world.
in priority areas of health research in leading III. Start-up grant for fellows undergone long
national and international institutions, encourage term/short term training supported by DHR:
and support the trainees to develop and take up
research projects for addressing critical national The Start-up grant, with an average cost of Rs.
and local health problems and financial assistance 30 lakhs per research project, for three years, will
to Institutions for up- gradation of infrastructure to be supported. In the year 2020-21 (till Dec 2020),
enable such Institutions to provide training with 13 start-up projects have been continued to be
state of the art technologies. supported under HRD scheme.
7.2 The scheme was approved during 12th Five IV. Fellowship Programme for Young
Year Plan period and support under the program Scientists:
is imparted in following categories:
This fellowships aims to fulfil the objectives of
I. Short Term Fellowship for training in Foreign creation of inclination / attitude of research among
Institutes/Indian Institutes: the young bright students from the medical colleges
Short Term Fellowship supports for training in / universities. In the year 2020-21 (till Dec 2020), 17
Foreign/Indian Institutes in identified areas (1-3 ongoing fellowships have been supported under
months) to persons employed as regular faculty this programme.
those who are not above the age of 55 years. A V. Fellowship Programme for Women Scientists:
stipend of $3000 per month for foreign institute
and Rs 40,000 per month for Indian institute is This fellowship aims to encourage women
being given to the fellows. During the year 2019- candidates to undertake biomedical research who
20 the programme was transferred to the ICMR for have break in their career. In the year 2020-21 (till
implementation. Applications for training in Indian Dec 2020), 15 ongoing fellowships have been
Institutions have not been invited during 2020- supported under this programme.
21due to Covid-19 Pandemic across the world.
VI. Support to Institute for imparting training:
II. Long Term Fellowships in India/abroad:
This program aims to provide support to selected
Long Term Fellowship supports for training abroad/ domestic Institutions for providing training. A grant
Indian Institutions in identified priority areas (6 to upto Rs.50 lakhs for equipments, up-gradation,etc.
12 months) is meant for the persons employed as and a grant of Rs. 10 lakhs per year upto a period of
regular faculty and those who are not above the 5 years for recurring expenses and for conducting
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Annual Report 2020-21
training programme. In the year 2020-21 (till Dec 7.3. Major initiatives of the Scheme in 2020-21
2020), 2 institutes have been supported under this • During the year 2020-21 (till Dec 2020), 49
programme for imparting training in biomedical
ongoing fellowships have been supported.
research.
• During the year 2020-21, the advertisements
VII. Strengthening of research through the for call for online proposals under 6 categories
establishment of online courses and web portal of HRD Scheme have been published in the
on health research for students, faculty and leading newspapers of English, Hindi and all
other researchers: the regional languages across the country*.
This programme will help prospective Institutions The categories are:
and individuals to access resources both financial 1. Long Term/Short Term Fellowship for
and technical on research and promote research training in Indian Institutes
across the country. This facility will include the
2. Fellowship Programme for Young Scientists
following facilities:
3. Fellowship Programme for Women
• Online courses along with contact
Scientists
Programmes in relevant institutions
4. Support to Institute for imparting training
• On line resource material for researchers in identified areas
• On line mentoring for researchers 5. Strengthening of research through the
establishment of online courses and web-
• Inter active forums and e-groups for
portal on health research for students,
researchers
faculty and other researchers
• other stakeholders 6. Research grant and fellowship to encourage
In the year 2020-21 (till Dec 2020), 1 institute/ Health Research Personnel [Non-resident
individual has been supported for online course Indian (NRI), Persons of Indian Origin
and programme. (PIO), Overseas Citizen of India (OCI)]
serving abroad, to come back to India for
VIII. Research grant and fellowship to encourage undertaking research in identified areas
Health Research Personnel [Non-resident Indian
* A total number of 366 proposals have been received
(NRI), Persons of Indian Origin (PIO), Overseas during call for online proposals for the year 2020-21.
Citizen of India (OCI)] serving abroad, to come The process of screening and shortlisting of these 366
back to India for undertaking research in proposals has been initiated.
identified areas:
III. Financial achievement of the Scheme in
This Scheme has been designed to provide 2020-21
contractual research positions to the Indian • In the year 2020-21, the Budget Estimate (BE)
scientists settled abroad who are willing to come of the scheme is Rs. 34.00 Crores, Revised
back to India on a fulltime basis or for short duration Estimate (RE) is Rs. 18.00 Crores and the
to pursue medical/ health research in India and take Actual Expenditure (AE) of the scheme is Rs.
up health research projects in collaboration with 6.04 Crores till December 2020.
Indian scientists, particularly in areas of national
priority. In the year 2020-21 (till Dec 2020), no 7.4. Status of Implementation of the Scheme
fellowship has been supported under this program Since the inception of the Scheme under 12th
so far. Five Year Plan, the achieved physical and financial
targets of the scheme are shown as below:
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Department of Health Research
7.5 Progress of scheme component wise in the financial year 2019-20 and 2020-21 (till Dec 2020)
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Annual Report 2020-21
54
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Annual Report 2020-21
56
Department of Health Research
1. Postgraduate Institute of Medical Education 14. Indian Institute of Public Health, Hyderabad
and Research (PGIMER), Chandigarh.
15. National Institute of Virology, Pune
2. Sree Chitra Tirunal Institute for Medical
16. All India Institute of Medical Sciences,
Sciences and Technology (SCTIMST),
Jodhpur
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Annual Report 2020-21
The Resource Hubs and Technical Partner so far have been depicted in the following map:
58
Department of Health Research
Key Phases of HTAIn Process • After the appraisal and approval of the
proposal by the TAC TP/ Resource Centres are
allowed to conduct the HTA study and after
completion of the study come up with the
outcome report and recommendations to the
TAC once again for appraisal of the outcome
and approval of the recommendations.
• Once the outcome report is approved by
the TAC it is submitted to the Board for final
approval. TP/Resource hubs may also be
called to present the outcome before the
board.
• The recommendations made by MTAB are
used to inform health services provided by
the Government like the National Health
Programs, the National Health Protection
Scheme (formerly RSBY), the National List of
Essential Medicines (NLEM), State-specific
Fig 5. Overview of HTA Process (At Macro Level) Health Insurance Packages, etc.
Progress of HTAIn:
The following is the progress of HTA studies that
PROCESS OF HTAIn have been deliberated upon and approved by TAC
• The User Department sends their topic(s) and HTAIn Board in the past:
to the Secretariat according to their priority A. HTA studies completed and approved by the
area with a clear policy question to conduct Board:
an assessment in order to address those
questions. HTA Studies
1) Health Technology Assessment of intraocular
• After prioritization Secretariat present the
lenses for treatment of age-related cataracts in
topic(s) to the TAC and a suitable Technical India
Partner/ Resource Centres is identified to
2) Cost‑Effectiveness of Therapeutic Use of
allocate those topic(s) to conduct the study. Safety‑Engineered Syringes in Healthcare
• The respective TP/ Resource Centres then Facilities in India
come up with a study proposal that contains 3) Health Technology Assessment of Strategies for
the policy question(s), research question(s), Cervical Cancer Screening in India – PGIMER,
Chandigarh.
objective(s), methodology, timeline,
manpower required and the estimated 4) Validation of Diagnostic efficacy of digital
hemoglobinometer (TrueHb), HemoCue and
budget. non-invasive devices for screening patients for
• The proposal is submitted to the TAC and the anemia in the field settings
TP/Resource hubs are called to present the 5) Health Technology Assessment of Uterine
same before the TAC in the TAC meeting held Balloon Tamponade for Management of
Postpartum Haemorrhage in India; NIRRH
at DHR.
Mumbai.
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Annual Report 2020-21
60
Department of Health Research
Multi-centric Studies: There are following multi- and develop efficient ways for collaboration. The
centric going on in different states across India: training was attended by all the PIs and Co-PIs of
the study.
I. EuroQoL-5-Dimension(EQ5D) study in India:
II. Costing of Healthcare Services in India: To
A. To facilitate the calculation of quality-adjusted assess the cost information from different parts of
life years (QALYs) that are used to inform economic the country, the study utilizes the Multidisciplinary
evaluations of health care interventions a multi- Research Units (MRUs) of DHR functional in
centric study is going on in the following institutes government medical colleges in different states of
located in the different representative zones of India. These MRUs along with the HTAIn Secretariat
India: in DHR and the HTAIn resource centre hosted in
i. PGIMER, Chandigarh. School of Public Health, PGIMER, Chandigarh is
identified and shortlisted as potential centres to
ii. JIPMER, Puducherry. gather this cost information.
iii. AIIMS, Bhubaneswar, Odisha. A. This study is conducted in 15 states/UT across
iv. NEIGRIHMS, Shillong, Meghalaya the country in following institutes:
vi. AMS, Lucknow, Uttar Pradesh. ii. Madras Medical College Chennai,
TamilNadu
iii. KGMU, Lucknow, Uttar Pradesh
iv. SMIMER, Gujarat
v. SMS Medical College, Jaipur, Rajasthan
vi. VIMSAR Burla, Odisha
vii. Seth GSMC and KEM Hospital, Mumbai,
Maharashtra.
viii. IPGMER, Kolkata, West Bengal
ix. IGIMS, Patna, Bihar
x. SV Medical College, Tirupati, Andhra
Pradesh
xi. PGIMER & Ram Manohar Lohia Hospital
New Delhi
xii. Government Medical College, Jammu,
Jammu & Kashmir
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Annual Report 2020-21
B. This multistate costing study aims to collect from healthcare centers. The second workshop was
cost information from 15 public tertiary medical intended to train the trainers with cost data analysis
colleges, 30 district hospitals and 40 private which was followed by refresher meetings with the
hospitals from across the above mentioned States. Investigators and data collection teams.
The First and Second National workshops for
training of the trainers on ‘Costing of Health Care C. The study was taken up in 2018 and since then
services’ were organized in PGIMER & DHR, MoHFW 855 packages have been completed. For first phase
respectively. wherein the investigators were trained of study, data collection and analysis for District and
with the costing methodology, familiarized with Private Hospitals in all states is ongoing. Now, the
the data collection tools & methods. It was also costing study has moved to its second phase. After
accompanied with field visits and data collection the completion of phase II, 1393 PM-JAY packages
will be covered by the study.
III. Establishing DHR-ICMR Advanced Government Medical Colleges that will ensure the
Molecular Oncology Diagnostic Services optimum utilization of facilities available there, in
(DIAMOnDS): terms of equipment and manpower and will also
provide the much required diagnostic services to
A. This Initiative aims to set up zonal oncopathlogy the cancer patients in those areas. A two-phase
labs to provide basic as well as high-end advance pilot development model will be followed. Detailed
diagnostic services to cancer patients and research Phase-wise Activities is provided in the DIAMoNDS
facilities for basic, translational and clinical Documents.
research. These laboratories will be established in
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Department of Health Research
3 North East TMC (Kolkata) Cachar Cancer Hospital and Research Centre
(CCHRC)- Silchar
RIMS, Imphal
IV. Price Regulation & Value-Based Pricing for A. This national level study will be conducted
Anti-Cancer Drugs: Implications for Patients, in collaboration with National Cancer Grid and
Industry, Insurer and Regulator: The study aims to data will be collected from cancer care centres
assess the impact of price regulation of anti- cancer associated with National Cancer Grid. The National
drugs on cancer patients, industry, insurers and Cancer Grid is a network of major cancer centers,
regulators. research institutes, patient groups and charitable
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Annual Report 2020-21
institutions across India with the mandate of C. The data collection is underway and it was
establishing uniform standards of patient care for planned to submit the report in the next couple of
prevention, diagnosis, and treatment of cancer, months but due to COVID-19 crisis the consultation
providing specialized training and education part is becoming a challenge.
in oncology and facilitating collaborative basic,
translational and clinical research in cancer. VI. Developing the Process Manual, Reference
Case and Guidelines for Budget Impact Analysis
B. Selected states for data collection proposed for India and Checklists for reviewing the
are Delhi, Tamil Nadu and Maharashtra, Haryana Proposals and Outcome Reports: The Process
Punjab and Assam. The proposed sites of data Manual for the HTAIn was developed in 2017
collection are: and there were gradual modifications with time.
The manual outline the steps for conducting the
i. Tata Memorial Hospital Mumbai health technology assessment in India and for
ii. Christian Medical College Vellore guiding the technical partners and organizations
conducting HTA analysis. There were gradual
iii. Adyar Cancer Institute Chennai, PGIMER modifications in the checklists and the recent
Chandigarh revised Process Manual is ready for TAC’s perusal.
iv. Government Medical College and Hospital The Reference Case for India is being developed
Chndigarh to provides a guide as to how HTA analysis should
be conducted and reported as part of the HTAIn
v. AIIMS New Delhi program of work. This ensures that the way in
which all analyses carried out are done in the same
vi. Dr. BB Borooah Cancer Institute Guwahati.
way, according to the same fundamental methods
V. Costing of Janani Shishu Suraksha Karyakram and principles. Reference case will enable HTAIn
(JSSK): or other institutions and individuals wanting to
use economic evaluation to inform their decisions
A. Government of India launched Janani Shishu to do so in full knowledge of its limitations and
Suraksha Karyakram (JSSK) on 1st June, 2011 to relevance to the decision problem at hand. Further,
eliminate Out Of Pocket expenditure for pregnant adherence to reference case would increase the
women and sick new- borns and infants on quality, interpretability and transferability of future
drugs, diet, diagnostics, user charges, referral economic evaluations. Currently the Reference case
transport, etc. The scheme entitles all pregnant for India in underway and soon it will be presented
women delivering in public health institutions to in the TAC. The Budget Impact Analysis (BIA) is a
absolutely free and no expense delivery including relatively recent method for economic evaluation
Caesarean section. This initiative also provides for of health-care interventions and technologies.
free transport from home to institution, between BIA can be defined as a tool to assess the financial
facilities in case of a referral and drop back home. consequences, either additional or displacement
Similar entitlements have been put in place for all from existing allocation, of the introduction of a
sick newborns & infants accessing public health new health-care interventions or technology in a
facilities. Recently, a new study proposal was specific setting in the short-to-medium term. By
approved by TAC for conducting costing of Janani the generation of this document, a BIA guideline
Shishu Suraksha Karyakram (JSSK). for its conduct specific to Indian context is being
developed, allowing for the flexibility to estimate
B. This is an in-house study involving analysis the financial impact for different budget-holders
of secondary literature and clinical opinion from and at different organizational level within Indian
experts of AIIMS and PGIMER, Chandigarh. health-care system. Currently the proposal has
been approved in principle by the TAC and the
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Department of Health Research
Introduction To Economic Analysis For Sree Chitra Tirunal Institute for Medical 8-13 May, 2017
Health Technology Assessment Sciences and Technology, Trivandrum
Workshop On Systematic Review And Meta- Department of Health Research, in 29-30 May, 2017
Analysis collaboration with NIMS, ICMR
Orientation workshop with National Health Department of Health Research 29 June 2019
Mission, Tamilnadu NIRT, Chennai
3rd National Workshop on ‘Costing of Health By HTAIn Resource hub, PGIMER 10 - 13 Dec 2019
Services’ for new centres Chandigarh
Advance Health Technology Assessment DHR and iDSI and Imperial College 07-09 September 2020
Training (Virtual Platform)
HTA Sensitization Webinar for State DHR and iDSI 5th November 2020
Government Health Officials(Virtual
Platform)
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Annual Report 2020-21
HTAB Bill (2019): A HEALTH TECHNOLOGY inequality so that maximum people can have
ASSESSMENT BOARD BILL, (2019) has been access to quality healthcare at minimum cost in the
proposed to institutionalize the structure and country. As per pre-legislative consultative policy,
function of the HTAIn body. The Bill is to provide HEALTH TECHNOLOGY ASSESSMENT BOARD BILL,
for the constitution of a Board for providing (2019) has been uploaded on the website of the
evidences related to cost-effectiveness, clinical- Department i.e. htain.icmr.org.in inviting comments
effectiveness and safety of medicines, devices, from Stakeholders. As part of Inter-Ministerial/State/
vaccines and health programmes undertaking Union Territories consultation the draft HEALTH
Health Technology Assessment (HTA) studies for TECHNOLOGY ASSESSMENT BOARD BILL, (2019) is
decision making. It will evaluate affordability, sent to the respective Inter-Ministerial/State/Union
appropriateness and cost effectiveness of the Territories and comments and suggestions on the
available and new health technologies in India. It HTAB Bill, 2019 are being received. A draft Cabinet
will work on the objectives of maximizing health, Note is ready to be submitted to the Cabinet for
reducing 'Out Of Pocket' expenditure and reducing approval.
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9 Outbreak of COVID-19
CHAPTER Outbreak of COVID pandemic
Department of Health Research through Indian India as on 1st December has reported 94,62,809
Council of medical Research (ICMR), an autonomous confirmed cases with 1,37,621 deaths.
organization under its administrative control, has
been on the forefront to address public health Testing for Sars Cov-2
challenges and finding suitable solutions through Covid-19 pandemic is a National Health Emergency
research for the nation. of unprecedented nature and of historic scale,
which has rendered human life at risk. In the early
COVID-19 pandemic is amongst the largest public stages of Pandemic, National Institute of Virology,
health crisis faced by the World that is having Pune was the only testing centre for Sars Cov-2.
unprecedented negative consequences on health,
economy and our social lives. The WHO declared A strategy was adopted to enhance the testing
the disease a pandemic on March 11, 2020. Since centres and sample collection centres. The existing
January 2020, India has responded proactively Viral Research and Diagnostics established labs
to this pandemic by multitude of measures by were trained to undertake RT PCR COVID testing.
following the principle of ‘Test, Track and Treat’ and
Secondly Strategy was adopted to address the
has undertaken several measures to finally contain
constraints for procuring COVID 19 diagnostic
and manage the spread of the disease including
material. Empowered group-3 set up by the
international and domestic travel restrictions,
Government of India, cutting across ministries, was
rational screening and mandatory quarantine.
tasked with the objective of increasing procurement
One of the key strategies for containing the and ensuring regular supplies. Indian missions and
disease is to undertake widespread testing for embassies abroad helped identify global suppliers
COVID-19 followed by isolation and treatment of in a highly competitive seller's market.
confirmed cases and containment measures for
Thirdly Strategy was to partner with domestic
clusters of confirmed cases. The WHO recommends
industry to work towards self sufficiency in testing.
the real-time reverse transcription-polymerase
Because of the nationwide lockdown, industries
chain reaction (RT -PCR) diagnostic panel for the
faced severe operational challenges related to
detection of 2019 novel corona virus with 140
movement of human resources and procurement
tests per million per day, a strategy that India has
of material and machinery. A task force at DHR was
also adopted. Today more than 2100 laboratories
set up principally to ease out these challenges and
spread across the length and breadth of the nation
handhold the industry to accelerate production of
are carrying out the testing in the fight against the
VTM, RNA extraction kits and RT PCR kits.
spread of the COVID-19
The scale up of testing laboratories started with
a network of 106 DHR funded Viral Research and
Diagnostic Laboratories, (VRDLs), which already
had the capacity to conduct testing for viruses
similar to SARS-CoV-2. Subsequently, the testing
was initiated in partnership with laboratories in
DST, DBT, ICAR, CSIR, DRDO, MHRD, medical colleges
and private laboratories. Private laboratories that
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Annual Report 2020-21
had approval from the National Accreditation control for testing. States provided infrastructure
Board for Testing and Calibration Laboratories and manpower for enhancing testing centres.
(NABL) were accepted. With its testing capabilities
now matching the most advanced countries in the In India, 14,13,49,298 tests have been conducted in
world, Indian institutions have risen to the occasion the last 10 months. The maximum tests conducted
in an emergency situation. per day was 14.94 Lakhs on 24th September 2020.
The national average tests per million per day has
ICMR established 24 Mentor Institutes for increased to 414.
approving testing centres and assuring quality
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Testing Centres:
ICMR has 2170 approved centres for COVID 19 testing with 1176 government and 994 private labs.
Validation of Kits
1. ICMR has 24 centres which have been undertaking the process of validation. The institutes are as
follows
Number of Institutes
1 ICMR INSTITUTES 09
2 DBT INSTITUTES 05
3 CSIR INSTITUTES 03
4 OTHERS 07
Types of testing kits for diagnosis of Covid-19 and India is currently using
COVID-19 testing involves analyzing samples both open and closed systems of RT-PCR platforms
to assess the current (virus) or past (antibodies) (Open system RT-PCR machines and TrueNAT and
presence of SARSCoV-2 virus. Tests for viral CBNAAT also popularly known as GeneXpert).
presence include Real Time Reverse Transcriptase India recently introduced Antigen testing to ramp-
Polymerase Chain Reaction (RT-PCR) and Antigen up testing in containment zones for point of care
tests. Real Time RT-PCR is considered gold standard diagnosis.
The total Number of kits validated till 1st of December is 1099 with 394 indigenous kits
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Annual Report 2020-21
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Department of Health Research
V. Grant-in-aid Scheme for Inter-sectoral Convergence and Coordination for Promotionn and
Guidance on Health Research in North Eastern States:
(Rs. in lakhs)
S. State Name of the Institute Funds released
No.
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Department of Health Research
Indian Council of Medical Research (ICMR), New also includes research fellowships and short-term
Delhi, is the apex body in India for the formulation, visiting fellowships for up and coming researchers
coordination and promotion of biomedical research to expand their skills and knowledge early in their
and is one of the oldest medical research bodies in career. ICMR also offers Emeritus Scientist positions
the world. The ICMR is funded by the Government of to enable retired medical scientists and teachers to
India through the Department of Health Research, continue to carry out research on specific topics.
Ministry of Health & Family Welfare.
The impact of ICMR spans across the globe with
The Governing Council of the ICMR is presided research collaborations spanning every continent.
over by the Union Health Minister. It is assisted Through ICMR’s Memoranda of Understandings
in scientific and technical matters by a Scientific (MoUs), ICMR has partnered with leading universities
Advisory Board comprising eminent experts in from around the world to concentrate efforts on
different biomedical disciplines. The Board, in its leading health issues such as cancer, diabetes,
turn, is assisted by a series of Scientific Advisory infectious diseases, and vaccine development.
Groups, Scientific Advisory Committees, Expert These collaborations facilitate the exchange of
Groups, Task Forces, Steering Committees etc. scientific information, training, joint projects, and
which evaluate and monitor different research co-authorship of meetings, workshops, seminars,
activities of the Council. and symposia presentations.
The Council's research priorities coincide with Intramural Research
the National health priorities such as control Intramural research is carried out through a
and management of communicable diseases, countrywide network 26 institutes/centres with
fertility control, maternal and child health, multiple field stations, 14 work in the area of
control of nutritional disorders, developing communicable diseases; 6 in Non-Communicable
alternative strategies for health care delivery, Diseases, 1in diseases related to Reproductive and
containment within safety limits of environmental Child Health (RCH); 1 in nutrition and nutritional
and occupational health problems; research on deficiencies, 3 in disease related to Basic Medical
major non-communicable diseases like cancer, Sciences including heamoglobinopathies and
cardiovascular diseases, blindness, diabetes and traditional medicine, 1 in the area of animal
other metabolic and haematological disorders; breeding and research.
mental health and drug research (including
traditional remedies). All these efforts are Extramural Research
undertaken with a view to reduce the total burden Extramural research is promoted by ICMR through-
of disease and to promote health and well-being of Setting up Centres for Advanced Research in
the population. different research areas around existing expertise
ICMR has also demonstrated its commitment to the and infrastructure in selected departments of
future of medical research through its professional Medical Colleges, Universities and other non-ICMR
development training and capacity building. This Research Institutes. Task force studies are also
includes training programs, workshops, and short- carried out which emphasize a time-bound, goal-
term research studentships for those preparing oriented approach with clearly defined targets,
for a career in medicine and medical research. It specific time frames, standardized and uniform
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Annual Report 2020-21
methodologies, and often a multi-centric structure. individuals. The first sero survey demonstrated
0.79% prevalence and the second ser-survey
Open-ended research on the basis of applications
demonstrated 6.6% prevalence of SARS CoV-
for grants-in-aid received from scientists in non-
2 antibodies in the population.
ICMR Research Institutes, Medical colleges,
Universities etc. located in different parts of the • Promoting Make-in-India Efforts: ICMR is
country. validating COVID-19 diagnostics through fast
track mechanism. Till now, 135 (out of 285)
Achievements during the year:
RT-PCR kits, 25 ELISA/CLIA kits, 27 (out of 173)
• COVID-19 Pandemic: ICMR has been at the rapid antibody test kits have been found to
forefront in the fight against Covid-19. The be satisfactory. Also, ICMR is handholding
major achievements in this area are listed domestic players to expedite production
below: of diagnostic supplies through all possible
support. The Capacity has been developed
• SARS-CoV2 virus isolation: India is 5th in the
for production of 10 million RT PCR test and
world to isolate SARS-CoV2 virus. It aided in
5 million RNA extraction kits. Capacity of
COVID-19 testing development (ELISA) and is
VTM (Virus Transport Material) production
the starting point of fully indigenous vaccine
is up-scaled from 5L VTM tubes/yr to 5L
development. Also, ICMR is 1st in the country
VTM tubes/day. Synthetic swabs, used for
to sequence the complete genome.
sample collection, were not manufactured in
• 24X7 operational pan-India Lab network: India earlier and now the current in-country
In a very short span of time, ICMR led the production capacity is `1 Lakhs swabs/day.
building of testing grid consisting of 2045 Efforts are on to ramp up the production
laboratories spread across the nation from capacities of all supplies.
islands of Andaman & Nicobar, the tough
• Vaccine Development: ICMR has partnered
terrain of North Eastern region to difficult and
with Bharat Biotech India Limited for
hard to reach areas like Leh, Ladakh at 18000
indigenous vaccine development. The vaccine
ft. Today, we have testing capacity of `14 lakh
candidate has successfully completed phase I
tests/day. Exponential increase in testing has
and II clinical trials and approval for phase III
led to early identification, prompt isolation &
has been granted. Also, ICMR has partnered
effective treatment of Covid-19 cases along
with Serum Institute of India (SII) and Oxford
with effective contact tracing. These have
University to fast-track clinical trials of the live
eventually resulted in a sustained low fatality
attenuated recombinant vaccine. The vaccine
rate.
is under phase III trial.
• First Make-in India Covid Kawach ELISA
• Exploring the treatment options: ICMR
kit: ICMR developed a rapid, highly sensitive
is participating in WHO Global solidarity
human IgG ELISA kit for COVID-19. It helped
trial. The trial tested four repurposed drugs:
in conducting the National Sero-Surveillance
Remdesivir, Interferonβ1a, Lopinavir/
for guiding the future policies of COVID-19
Ritonavir and Hydroxychloroquine. Interim
control.
analysis showed that no benefits of Remdesivir
• National Sero- Survey of COVID-19: ICMR in any groups of COVID-19 (asymptomatic /
conducted two national level sero Suro- mild / moderate /severe /critical) patients.
surveys of COVID-19 to understand the ICMR also demonstrated that plasma therapy
proportion of population exposed to SARS- under current conditions is not effective in
CoV-2 infection including asymptomatic treatment of COVID-19.
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Annexure
BE/RE/actual expenditure 2019-20 and BE/RE 2020-21 with actual expenditure upto December, 2020 and BE 2021-22 in
respect of Demand No.43-Department of Health Research
(Rs. in crores )
Note: Figures include provision of Rs 104.00 crores in BE 2020-21 and Rs. 83 crores in RE 2020-21 and Rs.104 crores in BE 2021-22 under NE component.
81
* BMHRC has been merged with ICMR.
Design & Printed at: Viba Press Pvt. Ltd., 9810049515
D E PA R T M E N T O F H E A LT H R E S E A R C H
M i n i s t r y o f H e a l t h & Fa m i l y W e l f a r e
Government of India
New Delhi