India ranks 174th on air quality among 178 countries, according to the 2014 Yale Environmental Performance Index. Particulate matter in the air of 180 Indian cities was six times higher than the standard set by the World Health Organisation (WHO). Indoor and outdoor air pollution are now the third and fifth leading cause of death in the country, causing more than a million premature deaths ever year.
The main pollutants in the air are sulphur dioxide, ozone, various oxides of nitrogen and particulate matter of different sizes. Breathing polluted air slowly leads to diseases that affect the lungs, the heart and even the brain. That pollution causes these diseases may not be immediately evident, but the WHO’s large data collection points unequivocally to the causal link.
All shook up
What is probably more troubling is that the problem has suddenly got worse. The number of deaths caused in India by outdoor air pollution has increased six-fold since 2000. A number of factors have contributed to this rise: reliance on and increased use of coal-powered power plants, growing number of vehicles, improper urban planning and poor enforcement of regulations.
Just like clean water, clean air is a public utility and governments have a duty to ensure that these are available to its citizens. Central and state governments have been making some changes, but they haven’t helped much. In Delhi—judged by the WHO in May 2014 as the city with the most polluted air among 1,600 cities across 91 countries—the government has tried to implement various schemes, such as the use of natural gas for public transport, but without much improvement in air quality.
Air pollution has a negative effect on the economy, too. According to the World Bank, its ill-effects cost India ₹ 3.3 lakh crores annually, which is 3% of the gross domestic product. Not enough is being done to address the problem.
A little less conversation, a little more action please
I believe the problem is so huge that it is too late to wait for government’s actions to protect our health. Fortunately, there are steps that citizens can take to deal with air pollution, which can significantly increase the quality of the air we breath.
If you or someone you know burns wood for the purpose of cooking or heating water, you could improve your health by stopping or altering this practice. Most cookstoves of this kind do not burn the wood efficiently, releasing very harmful particulate matter. If you cannot afford to replace wood with natural gas for cooking, the cheaper option would be to buy a subsidised improved cookstove available from government outlets.
The easiest way to deal with outdoor pollution is to wear a mask. Look for N95 masks which are relatively easy to find and fairly cheap. Whatever mask you buy, ensure that it covers your nose and mouth fully, because any air gaps will render the effort ineffective. Masks are not as uncomfortable as they look, but they are definitely not stylish. Yet, by wearing a mask, you are not just taking care of your health but also making a public display of protest against the government whose duty it is to ensure that air quality be improved.
The final thing you can do to deal with outdoor pollution is to plant trees, specifically outside your house. A recent study by scientists at Lancaster University showed that a line of young birch trees outside the house can cut particulate matter entering the house by half. Trees are also highly effective when planted along busy roads, because they can absorb not just carbon dioxide but also ozone, sulphur dioxide, nitrogen oxides and carbon monoxide.
For too many years we have taken the air we breath for granted. We have ignored the risk that the tragedy of the commons could afflict this abundant public utility. Let’s hope we can fix it before it’s too late.
“After he became chairman and chief executive in 1982, he improved productivity and sales, and acquired several companies, including STP Oil. Ecologists said Union Carbide began shaking off the reputation as a polluter that had long dogged it. Mr. Anderson ruled over an empire with 700 plants in more than three dozen countries. Then came Bhopal. For the first time in his life, Mr. Anderson couldn’t sleep; at one point he holed up for a week at a hotel in Stamford, Conn. He and his wife, Lillian, spent evenings reading newspaper articles about the tragedy to each other. When they went to restaurants, he was afraid to be seen laughing because people “might not think it was appropriate,” he told The Times.” (5 min read, The New York Times)
““The algorithms we have developed run on a smartphone-like platform and do this evaluation automatically. It doesn’t require the intervention of a skilled technician. While the qualitative test results can be known instantaneously, quantitative parasitemia levels are assessed and displayed in about 30 minutes,” said Gorthi. The scientists also believe that this portable handheld device can be modified for diagnosing other diseases as well.” (3 min read, LiveMint)
“In large part it is because supermarkets are not a compelling draw in terms of price and service. Most shoppers in India buy dairy products, vegetables and fruit either daily or every two to three days, and the traditional trade has a lock on these frequent purchases, according to research by the Boston Consulting Group (BCG). Its hold weakens a bit (and the appeal of supermarkets correspondingly tightens) on rich consumers and for less regular purchases: packaged foods; soaps, detergents and other groceries; and staples, such as rice and grains (see chart). But in general even affluent consumers prefer traditional stores, because they are closer to home, are usually open longer and offer credit to familiar customers. Many will deliver free of charge.” (6 min read, The Economist)
“Mr Modi’s claims are an inversion of the logic of faith; he is asserting that the supernatural, in this case the elephant-headed god, Ganesh, is not an instance of divine magic but the consequence of human technology. He is, if you like, offering us a secular explanation for a deity in the Hindu pantheon. If this is a reasonable characterization of his claims, then the closest parallel to the Prime Minister’s thinking is to be found not in the religious beliefs of other political figures, but in the speculative theories of Erich von Daniken. Von Daniken was an enormously successful Swiss writer in the 60s and 70s who wrote a series of best-selling books based on a single conceit: the idea that the artefacts of ancient civilisation were littered with signs that pre-historical human societies were raised from their primitive state by intelligent extraterrestrials” (7 min read, NDTV)
“In addition, Delhi’s four landfill sites extend over 164 acres, when the current requirement is nearly four times the available area – 650 acres, according to a 2011 report by the Central Pollution Control Board. “Even if people learn to dump their garbage at the dhalaos [a small garbage dump typically servicing a few streets of a neighbourhood], how will that help if thedhalaos can’t be emptied, since there are barely any space left in landfills,” Narain asked.” (4 min read, Scroll.in)
Chart of the week
“The death penalty divides public opinion in America and has mostly ended in Europe. But around the world, the number of places that carry out capital punishment and the number of people killed is rising. Executions took place in 22 countries last year, according to Amnesty International, a human-rights lobby. In America there were 39 executions—more than the known number of executions in Yemen, Sudan or Somalia. Countries whose gallows had been left unused for long periods put prisoners to death, notably Indonesia (for the first time in four years), Kuwait (in six years) and Nigeria (in seven years).” The Economist has more.
There is a saying in Tamil that goes “if your family can’t discipline you, the world will”. That would be the story of the slipshod trio of Wockhardt, Ranbaxy and Sun Pharma, three Indian pharma companies whose drugs have been banned by the US Food and Drug Administration (USFDA), leaving Indian doctors and patients facing a dilemma nobody deserves. On the one hand, these companies’ drugs have no substitutes in the market. On the other, neither their quality checks nor the government regulatory body’s are trustworthy. While culpability swings from deficient manpower to lax rules, what drugs are doctors prescribing? (4 min read)
The Indian Institute of Science wants to construct India’s biggest particle accelerator, but for years the desire has not even materialised into a concrete plan. The difficulty? It cannot afford the cost of construction of nearly Rs. 2,000 crore without help from the central government. But the excuse belies a more visceral problem: the Indian science community has a vacuum at its helm, and it shows. Other developing nations are doing much better. Brazil, arguably India’s peer, is already building its second synchrotron. (4 min read)
He has held more than 20 jobs before this, from being an English teacher in Saudi Arabia to being a body-double in a German film. However… “In the autumn of 2010, Stephen was living in a basement apartment in Vancouver when it struck him that his calling might be mirror therapy. He’d go where there were amputees in pain, give them a mirror and teach them how to use it. Cambodia was his first destination because it had an inordinately high number of amputees, and it was small and flat, which was important because Stephen was planning to bicycle with his mirrors.” (27 min read)
+ The author, Srinath Perur, is a Bangalore-based science and travel writer.
Any developmental project in India requires a government-approved environment impact assessment (EIA). However, two things can decidedly worsen its trustworthiness. First, the company whose project is to be assessed can choose who performs it, no doubt a controversial facility. Second, as the newly installed Indian government seems to be doing, assessments can be “fast-tracked” at the expense of quality. As a result, both biologically diverse and endangered ecosystems around the country are under increased threat. (5 min read)
Biotechnology, education and renewable energy research are the big winners in the 2014 Union Budget in India, at least in absolute terms. Relatively, however, the rise in funding (4%) is diminished by the rate of inflation (8%), while the slew of new IITs and IIMs are likely to exacerbate a spate of teacher deficiency. Also hanging in the balance is the approval for scientific mega-projects. Nonetheless, scientists are optimistic that things will improve by September, when the government will issue revised estimates of funding figures. (2 min read)
Chart of the week
After the awful 2013 communal riots in Muzaffarnagar, polling in the constituency was strongly and predictably polarised. In most polling booths, the party that won also secured more than 90% of the votes. But was this the case across all of the state of Uttar Pradesh? Apparently not, as this analysis and chart shows. Western UP had the most polling booths where the contest was a winner-takes-all, but the extent of polarisation became visibly moderated toward the east. More on this at DataStories.in.
The problem is not that there is too much information, but that there is too little of the right kind
In his brilliant book, A Short History of Nearly Everything, Bill Bryson shows through many examples how history often credits the wrong person. They show how being in the right place at the right time or publishing your ideas in the right publication so that the right people notice them is some times more important than having the idea.
For instance, today the great astronomer Edward Hubble is credited to have discovered that we live in an ever-expanding universe. However, it was an astronomer with the cheerily intergalactic name Vesto Slipher who should have got the credit.
Or take the example of Carl Scheele, a Swedish chemist, who discovered eight new elements—oxygen, nitrogen, chlorine, fluorine, manganese, barium, molybdenum and tungsten—and received credit for none of them. His work was either overlooked or made it late to publication after someone else had made the same discovery independently. The credit instead went to chemists of the English-speaking world.
And, if you’re still not convinced, try Josiah Willard Gibbs, who Bryson calls the “most brilliant person that most people have never heard of”. Between 1875 and 1878 he produced a series of papers on the thermodynamic principles of nearly everything but published them in the Transactions of the Connecticut Academy of Arts and Science, a journal that “managed to be obscure even in Connecticut”. Although Gibbs was recognised later in life, most of the work he did remained hidden for too long at great cost to the scientific enterprise.
The reason I am telling you all this is not just because it is interesting, but also because there is a lesson we can learn from these examples. All three scientists who got scooped lived in the age when information was scarce and the fastest it travelled was at the speed of a moving vehicle.
We live in the age of information excess and the fastest it travels is the fastest it will ever travel (ie at the speed of light). However, we are still stuck with one problem that those gentlemen of the 19th century faced and perhaps it has become worse—who receives what information matters even more today. With the internet throwing up interesting things on our screens every day, are we getting the information we really need?
I’ll explain the problem with two examples. The first comes from how we learn history. This came to my attention during my first months in Oxford. Ask any non-Indian what they thought about British colonisation of India and you got a view that was quite different to what I was taught in school in India.
Most people acknowledged that there was imperial excess. They bemoaned the human cost of the partition between India and Pakistan, for instance. But they, particularly British friends, also praised how the British gave Indians railways, law and order, the English language, and, some even suggested, the Indian identity. Most importantly, they saw Indian independence as British leaving India. This was a time, one said, that Britain was relinquishing control of other colonies too following the troubles that World War II had caused for Britain domestically.
This wasn’t what I was taught in school. Indian textbooks glorify the independence struggle, it seemed. I was surrounded by some of the smartest people I had ever met, and instead of questioning them I had to go back and read history. What I realised soon though was that neither my British friends nor I had quite the balanced view that one ought to have of this important period in world history.
I wasn’t expecting my British friends to know about Mangal Pandey or Bhagat Singh, but I thought they would be aware of the Quit India Movement and Jallianwallah Bagh massacre. That they would recognise the importance of the role of freedom fighters, such as Sardar Patel, in accelerating India’s independence. Equally, I suspect my British friends thought I should have more appreciation for the things the British left in India.
The point here is that where the information came from changed how people viewed the world. In this case the topic was a well-studied period of history, and so I was able to educate myself enough to get a balanced view. But what about more recent events?
In The Sceptical Patriot, Sidin Vadukut analysed history textbooks used by Indian kids today. He found that none of them devote any space to post-Independence period. Beyond a little bit on the Indian constitution, there is nothing about the wars with Pakistan and China or about the Naxal movement, which is considered the greatest threat to India’s internal security.
Why should Indian kids learn about this stuff? Vadukut’s story might give you an answer:
Sometime in 2002 or 2003, a group of Japanse Hibakusha, or atomic bomb survivors, visited Chennai. The city was a stop on what I think was a global tour to promote peace and condemn nuclear weapons. They decided to visit a primary school and tell the students why the idea of nuclear weapons was a bad one.
I read about the school visit in one of the local newspapers. I don’t recall which one, and no amount of searching online has thrown up the original news report. But the broad details of what happened are seared into my mind.
After the presentation, the Hibakusha asked the children: should countries go to war? No, they all said in chorus. Should countries use nuclear weapons? No. Should India use nuclear weapons? Never. What if the enemy is Pakistan? Oh, Pakistan is a special case, the kids said, we should totally nuke them.
Every time I retell this story at a public forum, there is an explosion of laughter followed by an awkward silence.
Absence of proper facts
This brings me to the second example, which is closer to me—science journalism. The media landscape of the west is changing. The old media houses are losing audience and revenue at such a pace that it feels like a crisis. The first to lose their jobs in such cases tend to be specialist journalists such as those covering science, environment and health. Sometimes the sections live on, but they shrink in size and depth. The reporting gets done by general reporters instead.
There have been some positive changes with new media organisations trying to fill the gap. And despite all that, even with shrinking newsrooms, western media’s science coverage remains so much better than Indian media’s. A survey I did a few years ago of Indian newspapers gives the same results today—proper science reporting doesn’t exist.
This is a problem. Most of the time if you come across a science story in Indian newspapers, it happens to be one from an international wire service, such as AP, Reuters or The Guardian. Despite the international nature of science, Indian readers are fed the writing of western journalists. The stories become less relevant and thus less interesting. While the hard-science stories are still somewhat valuable, those about the environment, health or even technology aren’t.
This matters because policy depends on the quality of information that decision-makers get. One more example from Vadukut’s book makes that case absolutely clear. In March 2008, Daggubati Purandeswari, the then minister of state for human resource development, when talking about India’s education system, parroted “facts” about Indians abroad, which had been forwarded in a hoax chain email.
“Sir, as rightly pointed out by the honourable member, our students have been placed very well globally. For example 12% scientists in the United States are Indians. We have 38% if the doctors in the US who are again Indians. 36% of NASA scientists are again Indians. So, the students are doing very well, and they are reaching places which again reflects on the quality of education that is being provided to our children in the country.”
All of these “facts” can be easily verified as being false, but the honourable MP did not think she needed to do that. Her words were then reported in Times of India the next day as “facts”. And that is how facts get made up.
That aside, had there been good science journalists writing about the achievements of scientists in India, perhaps Daggubati would not have relied on information from dodgy sources. India’s premier institutes, such as the Indian Institutes of Technology, never figure in the world university rankings. From the information available to the minister today, she won’t be able to figure out whether the absence of IITs in such rankings says something about the poor quality of research or the lack of communication of that research.
There is also another side to this story. In my time at Oxford, whenever there was a paper published in an Indian or Chinese journal, I was explicitly advised not to give it too much value. The suggestion was that research in these journals was not reliable, which in other words means that the researchers were making up data.
This kind of opinion may have been formed by experience. But mostly this opinion was the result of western media reporting negative science stories emerging from China and India, which make academics wary of trusting such research. This, I believe, must lead to missing out on genuinely good research being produced in these countries.
The solution, of course, is one that will require change from the big editorial houses. In my conversations with Indian journalists, I’ve been told many times that there is thirst for good science content but no publication is ready to provide it.
A different solution that a friend and I are pursuing is to collate good science stories from around the web that have their focus on the other side of the world. While this doesn’t solve the need for more science reporting, at least it provides a central place to find good content related to India. Some of it exists, but sadly it tends not to be at one place but spread across different publications. (You can sign up for our newsletter here.)
Those gentlemen in the 19th century suffered personal loss because key information didn’t reach the right audience. Today’s tragedy is the same but the reason is different—key information is not reaching the right audience because either there is too much information and very poor filters or there aren’t enough people to collect and present the information that is so desperately needed.
Nearly 400m people live in cities in India and during the next 40 years that number will more than double. Not only is the proportion of India’s total female population that is economically active among the lowest in the world, but urban areas do even worse. New analysis of data from the 2011 census shows only half as many urban women work as their rural counterparts.
Few states – including Iran, Pakistan and Saudi Arabia – do worse than India when it comes to women’s participation in the workforce. Others such as Somalia, Bahrain and Malaysia do much better. Among the BRICS (Brazil, Russia, India, China and South Africa) which are comparable emerging economies, India has the lowest female participation rate, with only 29% of women over the age of 15 working. As the chart below shows, even among the MINT countries – Mexico, Nigeria, Indonesia and Turkey – only Turkey has the same participation rate as India.
In mainly agricultural economies, urban women often find less work than rural ones. Half the working population in India is employed by the agricultural sector. But agriculture’s contribution to Indian economy has been steadily falling and is now less than half that of the services industry. This should have corresponded with rapid growth in numbers of working women in cities, but that hasn’t happened.
Economists have tried to understand this discrepancy. Some cite the problem to be India’s unemployment rate among the young, who make more than half of the population. But such joblessness should affect both men and women, and it also doesn’t explain the long-term trend of low women’s workforce participation rates. Others believe that younger people in cities are staying in education for longer. While that certainly contributes to the overall picture, it cannot explain the large difference between urban and rural figures.
Some discrepancy may arise because many women are involved in home-based work and are part of the informal sector, where their contribution tends to be under-reported. “Better enumeration will help, but measurement is not the only reason participation rates are so low in India, especially in urban areas,” Sher Verick, a senior fellow at the International Labour Organisation, said.
According to Verick, the two main factors keeping women at home are social customs and very low education levels among women.
Breaking such customs is hard. Preet Rustagi, joint director of Institute for Human Development in Delhi, said: “To a certain extent, men control women’s lives. And women have internalised this as the norm. In such situations, the little work they do is the result of compulsion, such as when the household income is not enough, rather than choice.”
The power of social norms may be partially explained based on data from the city of Leicester in the UK, where one in four city-dwellers is of Indian background. According to a 2010 report by Sheffield Hallam University: “Economic activity rates among Indian women in Leicester are nine percentage points lower than for Indian women nationally.” In a large enough group of Indians, those social norms are more strongly held than when Indians are widely dispersed in the rest of the UK.
Although education levels have improved in recent decades, not as many educated women have found work.
“In India, there is a U-shaped relationship between education and participation of women in the workforce,” Verick said. “Illiterates participate more out of necessity. Women with a middle-level education (below graduate) have different aspirations and can afford to remain out of the workforce. Only better educated women have been ‘pulled’ into the labour force in response to better paid opportunities.”
Rustagi said a skills shortage among women is also to blame. “There is a large divide between what they can do and what jobs are on offer.” For instance, the lowest worker sex ratio is seen in construction, manufacturing and the retail trade, which are booming in cities.
The safety of women is also a concern in Indian cities, as was highlighted after the 2012 Delhi gang rape case. Better governance and improved policing ought to help, but urban India’s gender imbalance is a deeper cause for worry. The national average is 940 females per 1,000 males, but that drops to 912 for cities with a population larger than 1m. The imbalance is greater still in India’s biggest cities, with Delhi at 867 females per 1,000 males and Mumbai at 861.
The discrepancy in these figures may be partly explained by the mass migration of workers, mainly men, from rural to urban areas, according to Varsha Joshi, director of India’s census operations. But the drop is large enough that further investigation is needed to spot other reasons.
There are some positive signs. According to India’s National Sample Survey, the proportion of working women in urban areas has increased from 11.9% in 2001 to 15.4% in 2011. Rustagi said: “One of the fastest-growing sectors for urban working women has been domestic work. About 1.5m urban women were added to that sector in the last decade, which is more than one in ten jobs created for women in that time.”
But the areas that have shown the most significant growth, such as domestic work, tend to fall into the category of “informal” work – and under India’s labour laws, these workers have few workplace rights. This makes it harder for women to have sustainable jobs, let alone a career.
Indians go to the polls in April and, partly as a result of the focus of women’s issues, most parties have adopted promises about women’s empowerment as part of their campaigns, but none have spelt these promises out in any detail.
The Aam Aadmi Party has done the impossible. One month ago, the Facebook class of India loved them for showing what Indian politics really needs. Now they hate them for doing things that we won’t expect even corrupt politicians to do.
To understand this schizophrenia that the AAP has created among the educated middle class of India, we need to look at our own expectations. The success of Kejriwal in the Delhi elections, we thought, was the result of our disgust of the current political class. We hate those politicians who go after vote banks only so that they can fill up their own pockets with bribes. We wanted someone who could clean the muck and put worthy leaders in charge. Like Obama, he was the beacon of hope in a mess that had been decaying for decades.
As soon as he took up his place as Delhi’s chief minister, we expected Kejriwal to behave like a model chief minister—honest, sober and efficient. We wanted him to get things done. But unlike Obama who crushed the American dream after being re-elected, Kejriwal’s party members seem to be on track to crush our dreams within months of being in the government.
The law minister Somnath Bharti was accused of taking law into his own hands. The resident poet Kumar Vishwas was caught on camera making racial comments. And the leader Kejriwal was blamed to act un-statesmanlike when he resorted to protesting against his state’s police—something no chief minister had ever done before .
And yet, we must realise that Kejriwal is smart to know that pandering to our desires is impossible in the few months he has before national elections. He is partly right to blame the media for creating a hate campaign, for whom he has been a bonus. With Kejriwal, the media has one more top politician to poke beyond Rahul Gandhi and Narendra Modi.
Kejriwal’s best strategy for the national elections is going to be the same strategy he had going into Delhi elections—try to get enough seats so that AAP can be a trouble-making opposition. And for achieving that goal, it would be best to stick to the principles that won him Delhi. Something that even the Congress and the BJP have admitted to learn lessons from. The principles were to provide the people an alternative to the current crop of filthy politicians.
Of course, national elections are going to be a whole different game. Delhi’s population is all urban, but India remains largely rural.
In the Delhi elections, AAP got 30% of the votes, slightly behind BJP’s 33% and slightly ahead Congress’s 25%. He won not because of the few votes from the Facebook class, but mostly because of the votes from the poor—the rickshaw drivers, the slum-dwellers and lower middle class (which can afford mobile phones but has no use for the internet).
He succeeded because he acted as he had done for many years before—like a revolutionary. While it would be foolish think that he does not enjoy the power of being a chief minister, I would like to believe him when he says that he does not want that power if he has to compromise on his ideals. The Congress can pull remove their unconditional support and he won’t be chief minister anymore.
At this point I should disclose that I do not support Kejriwal’s economic policies, at least the ones he has shown so far. But I’m willing to experiment with having a clean politician who improves the functioning of the government and exposes its predecessor’s wrongdoings, even if the immediate effect on people’s lives will not be beneficial.
Rise of the muffler man
I like Vir Sanghvi’s clarity of thoughts. That is why when he said, “Kejriwal has become no more than a media-blaming, vote-bank politician”, I entertained his well-laid arguments seriously. Sadly, the conclusion drawn is only partly right.
Yes Kejriwal blames the media, but he is no vote-bank politician. Sanghvi’s analysis fails because he is being short-sighted. He claims that giving free water and cutting electricity prices in Delhi will get Kejriwal votes at the national level.
Kejriwal got into politics to play the long game. He recognises that what few votes he can get at the national level will come from exposing the tainted politicians, offering a good alternative and listening to the vast majority of people. He is moving the debate away from pitting personalities against each other to talking about values and ideas.
Like in Delhi, there is no way that AAP can form a majority government at the national level this year. It would be lucky if it even played a small part in forming the government. Instead, the AAP is aiming for the election of 2019. In five years, the party will have matured and the country will have grown tired of Modi. That would be the time when AAP will be a serious alternative—something Indians have been wanting for decades.
Daily jabs of insulin are a painful reality for many with diabetes. That may change if researchers who have successfully tested oral insulin in rats are able to replicate those results in humans.
Nearly 350m people worldwide suffer from diabetes and that number is predicted to grow to more than 500m by 2030. While the more common form, type-2 diabetes, does not always need insulin treatment, nearly quarter of all diabetes patients depend on insulin jabs. Oral insulin’s estimated annual sales could be somewhere between $8 billion and $17 billion.
The benefits of an insulin pill are more than just ease of taking the drug. The pill will mean that patients can start taking insulin earlier in the development of the disease, which could reduce some of the secondary complications, which can include blindness and impaired healing that leads to amputations.
The idea of oral insulin has been around since the 1930s, but the difficulties of making it seemed too big to overcome. First, insulin is a protein – when it comes in contact with stomach enzymes, it is quickly destroyed. Second, if insulin can pass through the stomach safely, it is too big a molecule (about 30 times the size of aspirin) to be absorbed into the bloodstream, where it needs to be in order to regulate blood-sugar levels.
Sanyog Jain at India’s National Institute of Pharmaceutical Education and Research and his colleagues have been working on delivering insulin in the oral form for many years. Their first fully-successful attempt came in 2012, when they developed a formulation that successfully controlled blood-sugar level in rats. But the materials used were too expensive to consider commercialising the technology.
Now, in a paper published in the journal Biomacromolecules, they have found a cheaper and more reliable way of delivering insulin. They overcome the two main hurdles by, first, packing insulin in tiny sacs made of lipids (fats), and, second, attaching to it folic acid (vitamin B9) to help improve its absorption into the bloodstream.
The lipids they use are cheap and have been successfully employed to deliver other drugs before. These help to protect insulin from being digested by stomach enzymes, which gets it to the small intestine. When the lipid-covered sacs enter the small intestine, special cells on its lining called microfold cells are attracted to the folic acid in them. The folic acid helps activate a transport mechanism that can let big molecules pass through into the blood. The amount of folic acid used in the formulation also seems to be in the safe region.
In rats, Jain’s formulation was as effective as injected insulin, although the relative amounts that entered the blood stream differed. However, it was better in one key aspect. Whereas the effects of an injection are quickly lost (in less than 6 to 8 hours), Jain’s formulation helped control blood-sugar level for more than 18 hours.
The most important part of the research comes after successful testing in animals – the formulation needs to be given to human volunteers. But, Jain said, “at a government institute like ours, we don’t have the sort of money needed for clinical trials.”
He may not have to wait for long, as big pharma companies have been searching for an insulin pill formulation for decades. Two of them, Danish pharma giant Novo Nordisk and Israeli upstart Oramed are in a race to come up with a solution. Google’s venture capital arm, Google Ventures, recently invested $10m in Rani Therapeutics with the hope it will help develop oral insulin. Indian firm Biocon also does oral insulin research, and it recently signed an agreement with pharma giant Bristol-Myers Squibb.
Oramed is ahead, with their oral insulin product soon to enter phase-II clinical trials, which is the most advanced stage any oral insulin formulation has ever reached. Its chief scientist, Miriam Kidron, said of Jain’s research: “Most people have the same basic idea to develop an insulin pill, but its the little differences that will determine ultimate success.”
While Kidron did not reveal Oramed’s formulation, she said, “we attempted liposomal delivery before, just like Jain’s work, but we weren’t successful.” She warned that translating success from rats to humans is very difficult. And she is right – most drugs have a high cull-rate at each stage of their development. Even so, research like Jain’s give hope that an insulin pill may not remain a dream for long.