2019 Yusuf Hamied Fellows: Columbia Mailman School of Public Health
Nutritional Policy in India Through a Pediatric Oncology Framework
Elena J. Ladas, PhD, RD
Sid and Helaine Lerner Associate Professor for Global Integrative Medicine
Division of Hematology/Oncology/Stem Cell Transplant in the Department of Pediatrics (in Epidemiology and in the Institute of Human Nutrition) at the Columbia University Medical Center
The double burden of malnutrition and the co-existence of undernutrition with obesity and overweight and chronic diseases, often in the same families and communities, is becoming an increasing, complex problem facing clinicians and public health experts in India. Malnutrition is a significant problem among children in India, where almost 50% are underweight, 48% are stunted (low height due to inadequate nutrient intake), and up to 57% are deficient in several vitamins and minerals. These figures are only exacerbated when a child is faced with a diagnosis of cancer. This proposal aims to convene stakeholders advancing nutritional training programs in India; explore the public health research aspects to these challenges, and develop potential pathways to policy recommendations in this critical area. Through Columbia Global Centers | Mumbai, we will establish a forum for training, research, and advocacy-related collaboration and mentorship for new and established clinicians to refine their clinical work and identify prioritized research questions and collaborations.
Dr. Ladas is an international clinical investigator with expertise in the design and conduct of pediatric nutrition trials addressing both under- and over nutrition in children with cancer. In collaboration with the World Health Organization, Dr. Ladas is the lead of a global initiative improving the delivery of care to children with cancer undergoing treatment in low- and middle-income settings. For the past eight years, Dr. Ladas has worked closely with several academic institutions located in several regions in India improving the knowledge, capacity, and quality of nutritional research among Indian children with cancer.
Effects of Environmental Exposures on Breast Cancer
Jasmine McDonald, PhD
Department of Epidemiology
Mary Beth Terry, PhD
Department of Epidemiology
India has one of the highest rates of the most aggressive breast cancer, referred to as Triple Negative Breast Cancer in the world. Given the dramatic increase in breast cancer globally and specifically in India’s health landscape, particularly in young women under 50, there is a need for focused studies of environmental exposures that are changing over time. This project will lay the groundwork for an epidemiological study on breast cancer in India, with a specific focus on the health effects of air pollution and polycyclic aromatic hydrocarbon (PAH) exposure. This project aims to build a network with broad expertise that spans environmental health sciences, molecular epidemiology, medical oncology, data science and imaging, and public health dissemination and implementation. Dr. Terry and Dr. McDonald will partner with the Columbia Global Centers | Mumbai to identify and convene investigators, leaders, and key stakeholders from India who will help strategize, organize, and implement research opportunities for women with early onset breast cancer.
Dr. Terry, Professor of Epidemiology, has more than 20 years of expertise in studying biomarkers and PAH exposure, including the measurement of PAH-albumin adducts, DNA methylation and DNA repair capacity, and BC risk within the Long Island Breast Cancer Study Project, the Breast Cancer Family Registry, and the LEGACY Girls’ cohorts. These studies have demonstrated the detrimental health effects of PAH exposure in humans.
Dr. McDonald, Assistant Professor of Epidemiology, has specific expertise in molecular biology, cancer epidemiology, and biomarkers. Dr. McDonald’s research focuses on the impact of environmental exposures (e.g., PAHs, infection) during key windows of breast cancer susceptibility and examining the underlying immune and/or endocrine pathways mediating outcomes.
Effects of the Globalization of Patent Laws on Drug Prices and Access to Medicines
Bhaven Sampat, PhD
Department of Health Policy and Management
Before the World Trade Organization’s 1995 Trade Related Intellectual Property Rights (TRIPS) agreement, India did not allow pharmaceutical product patents. TRIPS changed this, requiring India (and many other developing countries) to amend its laws to grant drug patents. Since patents restrict competition, there has been widespread concern during and since the TRIPS negotiations that the new laws would increase drug prices and availability, strain national health budgets and restrict access to essential medicines in India for the poorest populations. This project will empirically assess the impact of the new patent laws on drug prices, generic competition, and access to treatment in India, including the penetration of generics, and develop policy implications for Indian and global pharmaceutical patent policy. Dr. Sampat will work closely with Indian experts in Mumbai and elsewhere, and interact with industry researchers and stakeholders, and economic and health policymakers during this project.
Dr. Sampat is an economist by training. He is also a Research Associate at the National Bureau of Economic Research. He brings globally recognized expertise in empirical analyses of issues at the intersection of health policy and innovation policy, he is currently working on an economic history of U.S. biomedical research policy, examining the effects of federal indirect cost recovery policy on academic institutions, developing and validating new measures of connections between public and private sector innovation, and assessing the effects of patents on prices, competition, and access to medicines.
2019 Yusuf Hamied Fellows: India
Impact of National Pharmaceutical Pricing Policy on Utilization and Affordability of Essential Medicines
Habib H. Farooqui, MBBS, MD
Associate Professor, Indian Institute of Public Health-Delhi
Public Health Foundation of India
Dr. Farooqui’s research will generate evidence on the impact of price controls on utilization and affordability of selected essential medicines in key therapeutic areas (antibiotic, anti-diabetics and anti-cancer medicines) using interrupted time series (ITS) analysis, a quasi-experimental research design. This research aims to inform policymakers and regulators on price control as a policy instrument in Indian context, related to medicine utilization and also unintended effects, such as manufacturers moving out of price controlled therapeutic areas.
Dr. Farooqui currently serves as Additional Professor at the Public Health Foundation of India (PHFI) and is the lead faculty on Pharmaceutical Economics and Infectious Disease Epidemiology at Indian Institute of Public Health – Delhi. Dr. Farooqui is a member of the Vaccine Centre at London School of Hygiene and Tropical Medicine, BactiVac Network at University of Birmingham, and Surveillance and Epidemiology of Drug Resistant Infections (SEDRIC) Consortium at Wellcome Trust. His research focuses on health policy and planning, and pharmaceutical economics.
Climate Change and Health and Health Hazards Related to Urban, Low-Income Settlements
Surinder K.P. Jaswal, PhD
Deputy Director (Research), Professor, Centre for Health and Mental Health
Tata Institute of Social Sciences, Mumbai
Dr. Jaswal’s project aims to understand the critical health challenges faced by vulnerable urban populations. These health challenges are currently poorly understood, with most research focused on health facility data. Her project aims to build research collaborations to explore and understand factors and issues related to health and climate change, particularly in urban areas in the Global South.
Dr. Jaswal is Deputy Director (Research) and Dean, Research and Development, and School of Research Methodology at the Tata Institute of Social Sciences. Since 1987 she has served as a Professor in the Tata Institute’s School of Social Work. Dr. Jaswal is the Associate Editor of the Indian Journal of Social Work and her research interests include social work education, public health, public mental health, disaster studies and social science research.
Childhood Development and the Health Impact of Air Pollution in India
Aditi Roy, PhD
Research Scientist, Center for Environmental Health
Public Health Foundation of India, Gurgaon, Haryana
Dr. Roy’s research would explore the effects of environmental exposure to pollutants on health outcomes in children that also have consequences on adult non-communicable disease development. Her project aims to understand the extent of current and future health implications and to identify modifiable factors that could be targeted for intervention.
Dr. Roy is a research scientist with the Public Health Foundation of India’s Center for Environmental Health. With training in nutrition, environmental epidemiology, and maternal and child health, Dr. Roy focuses her research on how environmental exposure, nutrition and diet impact health and disease development during childhood and beyond.