Taking the fight to the enemy: Fighting India’s increasing infectious disease burden with proactive capability building

In August 2024, of 5 reported cases of an infection in the South Indian state of Kerala, 3 resulted in fatalities. This infection, identified as amoebic meningoencephalitis or brain-eating amoeba infection, was linked to a pond filled with mossy green stagnant water,

The progression of amoebic meningoencephalitis is so swift that clinicians rarely ever get the requisite therapeutic window to save a patient. This means that the disease is almost always fatal. Its mortality rate is so high that globally, there are only 11 survivors of the disease.

The need for speed

However, something interesting happened in Kerala this time around. By guessing that there might be an amoebic meningoencephalitis case cluster, health authorities tracked other individuals with exposure to the contaminated water body. At the first sign that they had symptoms of the infectious disease – like pain in the neck or headaches – health professionals tested their cerebrospinal fluid, detected the presence of the amoeba, and were able to deliver life-saving treatment.

This is a breakthrough in the management of the brain-eating amoeba infection. It is evidence that with early identification and treatment, all is not lost in the fight against deadly diseases such as this.

In addition to a call for the Indian Council of Medical Research (ICMR) to study the prevalence of the disease in the state, the Kerala Health Department is also trying to get its hands on more of the drug Miltefosine. While the patients currently on the drug are stable, the drug is not easy to procure. This means that to remain equipped to fight the disease, the supply of the drug needs to be ramped up and fast.

A growing infectious disease burden in India

In 2024, India has been home to an increasing infectious disease burden, fueled in part by changing weather patterns.

In the west Indian city of Pune, heavy spells of rain with subsequent high heat and humidity have created ideal breeding grounds for mosquitoes. It is hardly a surprise, then, that the city’s mosquito-borne disease burden has seen a steep spike in the monsoon months.

By early August, 88 individuals in the city were hospitalised with the Zika virus which – like dengue and chikungunya – spreads through the bite of infected Aedes mosquitoes. By mid-August, the Pune district had reported 100+ cases – more than any Indian state district has ever reported. Of the 1,725 suspected dengue cases in the city this year, 1,238 were detected in the months of July and August. Of the 54 confirmed chikungunya cases, 44 were reported in the same months.

While these increasing numbers can, in part, be attributed to better surveillance, there is a clear pattern of an uptick in mosquito-borne viral fevers. Individuals with pre-existing chronic conditions – be it diabetes, metabolic disorders, liver issues or kidney problems – are more susceptible to severe phases of these diseases.

Treatments for infectious diseases

While mosquito-borne viral fevers are a growing public health concern in India, treatments for these diseases aren’t being developed fast enough.

Let’s take chikungunya, for instance. Every part of India is endemic for chikungunya. Beyond the infection’s effect on people’s health, a study in Frontiers in Microbiology cites the massive economic and productivity losses caused by the disease. While mutations in circulating strains have made the virus fitter, more easily transmitted, and capable of causing more severe disease, there are no licensed vaccines or antivirals available to prevent and manage the disease.

If the subcontinent is to effectively fight the growing surge of infectious diseases, this must change, and fast.

Deploying modular prefab factories to make health products where they are needed

As in the case of the amoebic infections in Kerala and the viral ones in Maharashtra, developing and manufacturing effective vaccines and treatments is the need of the hour. As is faster disease identification through better surveillance and testing. The need of the hour is proactive capability building.

Within the next couple of years, weather patterns are likely to continue to fluctuate. This doesn’t have to mean increasing disease burdens and unmanageable infections. There are solutions, if we’re willing to deploy them.

India already has a developed biopharmaceutical manufacturing ecosystem. As the “pharmacy of the world,” it produced Covid-19 vaccines for a large proportion of the global population, playing a major role in helping the world bounce back from an unprecedented pandemic.

As new and old infectious diseases – their spread exacerbated by climate change – plague the Indian population, there is a massive sustained opportunity for more creative problem-solving.

Capability development is needed across the biopharmaceutical value chain – from R&D and API (active pharmaceutical ingredient) manufacturing to downstream processes. Even in health surveillance, diagnostics, and accessible healthcare delivery, India has a long way to go to achieve true health equity.

How might these objectives be achieved? Why of course through rapid, scalable and cost-effective biopharma facility development of a high quality.

Speed, scalability, economy, and quality are the foundations on which PodTech™ and its podule™ technology are built. They are also the foundations on which a new Indian biopharma landscape can be built.

In the case of diseases like amoebic meningoencephalitis, speed is of the essence. If diagnostics and treatments are to be delivered to patients when and where they are infected, there is no alternative but to produce them locally. PodTech™’s podules™ can provide the cleanrooms required not only for research and manufacturing but also for laboratory testing and patient recovery. In other words, they have vital applications in diverse parts of the health ecosystem. Deploying this modular construction technology can be the difference between health and sickness, between life and death, between equity and the scourge of inaccessible medicines.

Despite its developed pharmaceutical manufacturing ecosystem, an evolving global disease burden means that not India, nor any other country’s work is done. Achieving health equity within an increasingly challenging epidemiological landscape is going to mean increasing adaptability and flexibility to address new diseases or resurgences of existing ones. It will mean developing regional health ecosystems that can support themselves and their population’s needs. It will mean adopting novel technologies like PodTech™’s podules™ to address novel problems.