Apollo Hospitals Educational & Research Foundation
"The new Patents Act has changed the global perception of India, which is now the preferred destination for Pharmaceutical business. While the Industry is set to undergo a major transformation with focus on discovery research, it could expect to gain a revenue of at least $10 billion in the years to come"
Dr. William A. Hasseltine
Founder of Human Genome Sciences Inc & Chairman and CEO of Hasseltine Associates
The Apollo Hospitals Educational and Research Foundation is an independent entity recognized by the Department of Scientific and Industrial Research (DSIR) as a "Scientific and Industrial Research Organization (SIRO)", to carry out research, educational and training programmes in quest of quality health care.
AHERF aims to undertake and promote scientific and medical research programs that have a bearing on the health, social, economic and industrial needs of India. AHERF leverages the strength of the Apollo Group of Hospitals, which lies in its competent clinicians and clinical researchers, a large number and variety of patients, state-of-the-art diagnostic and therapeutic technologies and an excellent medical records system.
Research of the highest quality can only be carried out by trained investigators. The institution's vision is also to create educational programs in basic and specialized areas, in areas where qualified human resources are much needed for the Apollo Hospitals Group as well as the nation.
The Roadmap for Research
The Research Task Force has evolved a futuristic roadmap for AHERF and has identified various areas for cutting edge research. These are as follows
- Basic and clinical aspects of stem cells
- Molecular diagnostics
- Development of new devices and drugs
- Personalized drug usage through pharmaco-genomics
- Areas in clinical research which are of national importance
- Health Economics
- Ethical and rational trial of new therapies and devices
- Integration of traditional medicine into modern health care delivery
- Establishment of reference intervals for laboratory values in Indian population
- Epidemiological studies on incidence and prevalence of various diseases.
- Delivery of health through telemedicine
- Generation of human resource for effective delivery of health care
Presence of AHERF in India
Basic and Translational Research
Genetic association of Coronary Artery Disease in Young Indian Adults
A collaborative initiative between AHERF and Institute of Genomics and Integrative Biology (IGIB), a CSIR Institution and National Institute of Biomedical Genomics (NIBMG), a DBT Institute, this study aims to identify genetic factors that may be associated with early incidence of coronary artery disease in young Indians.
Pathogen detection and discovery, using High Throughput Platforms
This program was developed to evaluate a high throughput platform based on microarrays to detect novel viral pathogens from patients with respiratory disease and encephalitis. This RVP Fast Tag technology provides a sensitive detection system that does not require viral culture, which is difficult to establish.
Molecular and functional characterization of Endothelial Progenitor Cells in Polycystic Ovary Syndrome (PCOS)
In a collaborative initiative between AHERF and Indian Institute of Technology, Chennai, a study was conducted to determine if circulating endothelial progenitor cells (EPC) could be identified in the peripheral blood of healthy women and women with PCOS.It is proposed to develop Studies in the next phase for identification of a potential marker for cardiovascular diseases.
Genomic Profiling of Breast Cancer
In a collaborative venture between Leading Pharmaceutical MNC and AHERF Chennai, putative "candidate biomarkers" have been identified in cancer of the breast. Using fresh samples and also formalin fixed samples of well documented cases from Apollo Hospitals, microarray analysis and proteomics study were carried out. The outcome of the study was published in Biomarkers in Cancer 2010. The data generated from this study, has formed the basis for a proposed Phase II to validate the gene markers in a larger study for development of a potential prognostic kit for breast cancer.
Stem Cell Research
This is one of the thrust areas identified by Apollo Hospitals. AHERF is spearheading the effort to prepare Apollo Hospitals to evolve into a leader in stem cells research. Towards this endeavour Apollo has focussed on a two pronged strategy to initiate point-of-care based clinical research projects and internally develop cells for basic research projects. Focus areas identified for clinical research are stroke, cardio-myopathy, non-union fractures, spinal injury and critical limb ischemia.
The CMBRC facility at Hyderabad, has successfully established the procedure for isolation and culture of bone marrow derived mesenchymal stem cells and the methodology for characterization of the MSC. A proposal to study the safety and efficacy of intracoronary injection of autologous human bone marrow derived mononuclear cells (MNCs) and mesenchymal stem cells (MSCs) in patients with chronic ischemic left ventricular dysfunction has been submitted for extra-mural funding.
Institutional Committee for Stem Cell Research and Therapy (IC-SCRT)s have been established at Apollo Hospitals Chennai, Hyderabad and New Delhi to consider all stem cell related projects.
Rural Health camps at Gandhigram
AHERF and Kasturba Hospital, Gandhigram signed an MoU to provide standard healthcare facilities to a population in the 300 villages in and around Gandigram Trust. AHERF organized medical camps, tele-medicine consultations and awareness programs for the staff and public through telemedicine from Apollo Madurai. About 22 healthcare screening camps were conducted covering a population of 6500. Analysis of the data is in process.
Estimating prevalence of anemia and obesity at Sivagangai
AHERF Chennai in collaboration with Apollo Specialty Hospital Madurai, Mother Theresa Education and Charitable Trust (MTEC), an NGO based at Sivagangai undertook a study to evaluate incidence and prevalence of anemia and obesity in 20,000 adolescent girls and adult women. An interim analysis of the data from this subgroup showed that 61% of the population was underweight and only 4% was overweight.
Prevalence of Non-Alcoholic Fatty Liver Disease in school children (5-10 yrs)
This ICMR funded study jointly conducted by AHERF and INCLEN intends to study the prevalence of NAFLD amongst children in the age group of 5-10 years who are either overweight, obese or normal weight and the association of this prevalence with metabolic syndrome. After completion of the study, the data shall be analyzed and afflicted children shall be counselled and interventional therapy (if required) shall be advised.
Clinical Trials and Research
AHERF is India's single largest site solutions organization having experience of coordinating conduct of over 650 clinical trials across several therapeutic areas over the last decade. AHERF comprises of over 80 Clinical Research Coordinators, over 200 Principal Investigators on its panel across 11 sites. AHERF conducts trials in phase 2, 3 and 4 wherein over 80% of clinical trials coordinated are international multi-centric trials.
AHERF has established a benchmark in terms of ethics compliance and standards across its sites. For multi-centric trials, AHERF has established a central ethics committee which is registered with the Office of Human Resource Protection (OHRP), US Department of Health whilst its institutional ethics committees at Chennai and Hyderabad are also OHRP registered. AHERF also has built an in-house capability in ethics and quality assurance for clinical trials across multiple sites.
Currently, AHERF is in the process of further consolidating new centers within the Apollo Hospitals wherein almost 11 new centers are likely to be part of AHERF sites for clinical trials in order to promote clinical research in a best-in-class trials management framework.
AHERF has been involved in technology validation studies with global companies from UK and Europe and is in process of entering into technology validation, customization and development.
BP apparatus validation: A sponsored collaborative research study with a German institution to validate the technology with Digital BP apparatus versus sphygmomanometer for use in India as per international guidelines. The outcome of the study conducted with 100 subjects enrolled as per criteria showed promising results. The publication for the same is expected shortly.
Another collaborative research project from a UK based company for upgradation of methodology in TB diagnosis was conducted. A pilot study with 100 samples were collected and analyzed with this technique and the results are expected shortly.
Research Grants Programme
AHERF with support of Indraprastha Apollo Hospitals has pioneered a Research Grants Programme to promote investigator driven clinical research within the Apollo Hospitals Group. As part of the first grants programme, all clinicians from across the group were invited to share ideas for research out of which 21 ideas were selected for proposal development. The authors of these 21 projects were awarded a sum of Rs 50,000 each to facilitate proposal creation. AHERF scientists conducted a peer review of select project proposals and thereafter 5 projects were finally submitted to Government entities such as ICMR and DBT. 2 more proposals are in the pipeline to be submitted.
Under its E-health initiatives, AHERF conceived concepts and implemented projects which strive to maximize the use of information technology for healthcare through mobile phones.
Use of mobile phones for providing Primary Healthcare
AHERF, Delhi undertook a preliminary field survey in an urban slum setting to collect data of common medical symptoms prevailing in the community. The objective of the project was to introduce an alternative model with Technology Intervention and assess feasibility of deploying such a service using mobile phones to access Primary Healthcare. Using the collected data, a project is being initiated in collaboration with Indraprastha Institute of Information Technology (IIIT), Dwarka.
Information on drug-drug interactions through mobile phones
Since prescription practices are not very robust and the awareness of drug-drug interactions is limited, information readily available would improve prescription practices. It would also be of assistance to pharmacists and even the patient himself. The objective of this study was to develop and introduce a service to check drug-drug interactions through the mobile phones. A database of the interactions was developed which included 3370 generic drug interactions, excluding topical preparations, and involved a total of ~ 27000 brands. A web based application was further developed for mobile phones and a pilot project was implemented
Rural wireless telemedicine project
The objective of this study was to provide mobile healthcare to the rural areas to characterize the incidence of illness in the rural community.This study was based on the concept of Hospital on Wheels (HOW), wherein a camp is set up using mobile vans equipped with equipments for patient health checkups and the results of the tests are then transmitted to the hospital's system using 3G enabled EDGE (Enhanced Data Rates for GSM evolution) technology. The pilot on 50 adult volunteers was successfully completed at a village near Vellore, Madurai
The broad objective of this initiative is to train and equip young professionals with the critical skills needed for clinical research.
Advanced Certificate Course in Clinical Research at PG level
In order to address the significant skill gap of over 50,000 clinical research professionals in India, AHERF commenced a post-graduate programme in clinical research at its Delhi and Chennai centers in 2008. The full-time one year Advanced Certificate Course in Clinical Research at PG level is now conducted across five locations including new centers at Kolkata, Hyderabad and Ahmadabad.. The course is affiliated to Anna University, Chennai and the curriculum, student selection, faculty, assessment and certification is done jointly with the guidance of the university.
A unique and unmatched feature of this course is an exclusive 6 months internship wherein AHERF students undergo an experience of observing diverse facets of coordinating a clinical trial under the guidance of primary clinical research coordinators within our hospitals. This ensures that the students from AHERF minimize their industry skill gap and are more ready for working in the industry and government.
Clinical study on traditional bone healing systems
AHERF is conducting a prospective study to evaluate the outcomes of management of simple fractures of long bones by traditional bone setting methods in comparison to the modern methods. The outcomes are defined by precise clinical criteria as well as radiological criteria. The results of the study are awaited with great interest, for a positive result opens up great possibilities of advancement of knowledge in fracture healing and osteogenesis.
AHERF has plans to enter into and has completed the preparatory work to collaborate with one of India's largest Ayurveda groups to commence clinical studies validating Ayurvedic systems of treatment of diseases such as irritable bowel syndrome, lower back pain and rheumatoid arthritis.
AHERF had successfully partnered with Sciformix to conduct a one-of-its-kind workshop on Pharmacovigilance wherein select leaders from the industry and Government participated. The pioneering nature of the workshop in context of a corporate hospital taking a proactive stand on this matter encouraged the National Pharmacovigilance chairman to declare Apollo Hospitals (Indraprastha) as the first corporate hospital in India to be a part of the national centers for PV. Subsequently an adverse drug reporting center was commenced at Apollo Hospitals Delhi and the same was replicated in 3 other locations.
Further, AHERF is in the process of coordinating preparations for the establishment of a self sustainable bio-bank for Apollo Hospitals which can be leveraged for patient stratification, patient optimization services, biomarker validation and drug screening services.
AHERF is also in process to initiate a unique project focusing on Clinical Validation of Healthcare Technologies which will cover aspects like Clinical Validation of new technology, customisation of international technology and Co-development of technology.
University College London (UCL), UK
A formal MoU was signed between University College London, (rated amongst the top 20 universities in the world) and AHERF in 2011. The collaboration will have a strong element of research which will be spearheaded by AHERF. The possible areas identified for research collaboration are prevention of the adverse effects of Diabetes Type II, epidemiology of hypertension, genetics of cardiovascular disease and infections after transplantation.
The collaboration will also encompass areas of training and awarding of joint degrees under the aegis of UCL and collaborative research.
Anna University, Chennai, India
'Advanced Certificate Course in Clinical Research at PG level' was jointly initiated in 2009 by AHERF and AU-KBC (Anna University - K B Chandrasekhar) Research centre of Anna University to meet the shortage of the Clinical Research professionals in the pharmaceutical industry and to bring out certified and trained Clinical Research professionals.
International Clinical Epidemiology Network (INCLEN)
AHERF forged a collaboration with INCLEN to strengthen epidemiological research at Apollo Hospitals. AHERF along with INCLEN won Apollo's first Government grant from Indian Council of Medical Research for conducting a study on non-alcoholic fatty liver disease (NAFLD) and is working towards initiating joint projects in hyper-tension, child and maternal healthcare.
Cell and Molecular Biology Research Center (CMBRC):
A state-of-the-art laboratory of molecular biology, genetics and stem cell research at Hyderabad was formally launched by the Chairman of Apollo Group, Dr. Prathap C. Reddy on 31st October 2010. This 3500 sq ft laboratory is equipped with class 10000 sterile facilities for the processing, culture and maintenance of stem cell lines. It also has the latest equipments required for Molecular Biology, molecular genetics and molecular cytogenetics. It is staffed by full time research staff including a Director, senior scientist, research assistants and support staff.
Institute of Reproductive Medicine (IRM), Kolkata
AHERF has also forged collaboration with the Institute of Reproductive Medicine, which has an excellent tissue culture facility and is involved in the isolation and growth of embryonic stem cells. It is proposed to expand the activities of this facility to strengthen ESC research.