After taking over as director, what message have you delivered within the organisation and outside to create a fresh impetus?
The basic research on oral saline or ORS was carried out in icddr,b. This organisation has a good reputation worldwide. But it is not enough simply to hold on to this reputation or standard. It must be taken to even greater heights.
There are two clear messages. First, each and every one of us must improve our skills. And then we have to concentrate on science.
Our country has a large population. We have many patients with many diseases. We have to put this facility for clinical trials to good use. No other country in the world has this scope.
We will keep the Sustainable Development Goals (SDG) in front of us. We will give importance to Bangladesh's priorities. The priority list will include development of maternal and child health, reduction in infant mortality, improvement in mother and child nutrition
What do you want to do that sets you apart from others, that will make you be remembered even after you depart?
icddr,b is a very complex place. There were executive directors even much better than me here in the past. But a sort of vacuum is emerging in icddr,b. Dr Ferdaus Quadri has almost retired. Dr K Zaman, Dr Shams-Al-Arefin are going on retirement. They are all much bigger scientists and researchers than I am. There will be a lack of scientists and researcher of such calibre. I want to create an environment where there no such vacuum appears.
We have the world's top scientists in our scientific advisory group. They have advised us to take up the 'A-Team approach'. We have started working to ensure that no leadership crisis emerges.
What sort of research are you attaching more importance to, clinical trials or public health?
We have a strategic plan for 2019-2022. The plan's term ends next year. We have two alternatives ahead of us now. Either we can draw up a new strategic plan or we can amend and improve on the old one. We have decided on the latter.
We will keep the Sustainable Development Goals (SDG) in front of us. We will give importance to Bangladesh's priorities. The priority list will include development of maternal and child health, reduction in infant mortality, improvement in mother and child nutrition.
It must be kept in mind that around 250 million mothers around the world are suffering from malnutrition. And 800 million people spend their days in hunger. Never before in the history of mankind have so many lived in hunger. Many of them are outside of the food safety net. We will research on preventing malnutrition with whatever food is available on hand.
This will require logistics, an adequate skilled workforce and funds. We are working on building up that skilled workforce and funds.
ORS is an important innovation. After that, what do you consider as the next most important innovation?
During the time of Bangladesh's independence, the reproductive rate was 6.5. In implementing the Dishari project in Matlab, icddr,b saw how the rate of contraceptive use could be increased and the TFR reduced by means of door-to-door visits. Later this Matlab model was replicated all over the country.
There was a time when tetanus was the main cause of maternal and infant mortality. icddr,b research showed that if a mother was given a tetanus vaccine, the child too was protected from tetanus. This spread all over the world. Some other important contributions of icddr,b include the cholera vaccine trial, identifying the presence of lead in infant formula, improving the state of nutrition through peer counselling and more. Reducing the intensity of diarrhoea with zinc was a significant life-saving innovation. Bubble CPAP invented by icddr,b scientists for the treatment of pneumonia in children received extensive acclaim. At the request of the Ethiopian government, our scientists are working on this technology there.
It would be a challenging task to become an organisation like the US National Institute of Health (NIH). Even so, what assistance or changes are required for icddr,b to become more important globally?
I have had the opportunity to observe how NIH works so meticulously. They strictly adhere to tried and tested methods.
We require scientists. We need to monitor if the science is being carried out accurately. We should take in good scientists wherever they are. At the same time, promising scientists and researchers must be nurtured.
What steps should the government of Bangladesh or the international community take to build up an institution like NIH?
Our scientists work on a project basis. A part of the project allocation is spent on administrative costs. Once the project ends, there is nothing left. Most of our annual budget is project-based.
We receive our core funds from Bangladesh, Sweden, Canada and the United Kingdom governments. The Bangladesh government has provided the space for the institution for which we are always grateful. The prime minister visited our institution and that is a blessing to us. But the government can increase its assistance further. It can create the opportunity for us to do research with other institutions.
The international community can contribute to our core fund. We treat over 200,000 patients in the hospital free of charge. And our laboratory expenditure is huge. If our core funds are increased, our scientists will get the opportunity to work more independently.
Scientists have to remain busy with science. However, if working on a project basis, a scientist also need to be involved in financial management, has to be adept at this. That is an added pressure.
That is reality. If we require funds for research from anyone, we have to create a project. We have to clearly state what results to expect. Then we have to give a budget for the work, mentioning all the details and costs.
The young scientists and researchers at icddr,b are provided training in these matters. New researchers pick up this skill of financial management when they are attached to the main researchers. And our finance department also helps the scientists in this regard.
There is another thing that is helpful. Scientists now work with many donor agencies. Their presence makes it easier to work with donors.
In many cases, donors have their own objectives. They have their prescribed forms and want the work to be carried out in a specific manner. The aims and objectives of many scientists are similar to those of the donors.
So the scientists of government organisations have a lot of conveniences.
They have both conveniences and inconveniences. In a government organisation, a scientist doesn’t have to arrange for funds. They get their salaries at the end of the month.
On the other hand, there are some inconveniences too. For example, there may be an ongoing research, but midway someone is transferred elsewhere. This harms the research and the scientist doesn’t benefit either.
I was surprised when I visited a government research institute in Indonesia. Their size and shape, workforce, budget, everything was much bigger than ours, but their output was less.
icddr,b’s scientific work or research is project-based. The scientists and researchers work as a team under the main researcher. When one project ends they try to start another. They have to compete on an international level to get these projects. Their skills are assessed. It takes anything between 8 to 12 months to get a project.
Our scientists often have to stay up late in the night because of all this. I work till 2 or 3 in the night on a regular basis and have been doing this for the last 20 to 25 years.
Now coming to science, you all carry out a lot of research. How far are the results of your research used by the general people and the policymakers?
We want to break away from our conventional trend. We are moving towards a system to demonstrate the impact of our research.
When one project ends, a scientist starts on another. He does not see or does not try to see the impact of his research or how far it has had an effect. This matter of assessing the impact is not included in the project and so he does not or cannot spend extra time or money on this.
We have taken institutional initiative for impact assessment of any research. This will be carried out by people outside of icddr,b. A donor will also be involved in this. This is an important agenda for icddr,b in the coming days.
How would you evaluate the 60 years of icddr,b?
icddr,b is located in Bangladesh. ORS has saved around 70 million lives around the world. This is a big gift to the entire world from Bangladesh. The scientists here have invented appropriate technology at low costs. Outside of research, innovation and publishing articles, regular training is being imparted to professionals, scientists and researchers to build up a skilled workforce. Every year 200,000 to 250,000 people receive medical treatment at the icddr,b hospital in Matlab and in Dhaka.
In the coming years icddr,b will place emphasis on working with non communicable diseases (NCD). Efforts will be made to gain a deep understanding of NCD. The main objective will be to stay involved in the initiative to provide people with medicines at low cost.
* This interview appeared in the print and online edition of Prothom Alo and has been rewritten for the English edition by Ayesha Kabir