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Celebrating Dr. M.K. Bhan: The visionary scientist behind India’s rotavirus vaccine

January 30, 2020 by Kanduri Ananth Balaji

Following his passing, we celebrate the generous life and world-changing contributions of Dr. M. K. Bhan.

Dr. M.K. Bhan. Photo: PATH/ K.A. Balaji

Dr. M.K. Bhan. Photo: PATH/ K.A. Balaji

The public health, scientific and medical community of India recently lost a guiding light when Dr. Maharaj Kishan Bhan, the renowned pediatrician, clinical scientist par excellence and former secretary to government of India’s Department of Biotechnology passed away after battling cancer at the age of 72.

Born in 1947, India’s year of Independence, Dr. Bhan’s life journey has been full of innovative initiatives for his country. He was a visionary and the driving force behind revolutionizing the country’s biotechnology landscape. He can rightly be called the father of ROTAVACÒ, India’s first indigenously developed rotavirus vaccine.

The ROTAVAC® story began more than three decades ago when Dr. Bhan discovered the rotavirus vaccine strain code named 116E during a diarrhea outbreak at a neo natal ward in AIIMS in New Delhi in 1985-86. He found that the initial infection protected the infants from recurrent severe episodes of rotavirus diarrhea. The visionary that he was, he immediately saw the possibility of this Indian strain being made into a vaccine that could protect millions of children from rotavirus diarrhoea.

His passion for the rotavirus vaccine continued even after he became the Secretary of the Department of Biotechnology (DBT). If anything, this position offered him more tools to transform the Indian biotech industry landscape through his vision. This led to the development of ROTAVAC® manufactured by Bharat Biotech International Limited, Hyderabad.

ROTAVAC® went on to become the first Indian rotavirus vaccine to be prequalified by WHO paving the way for its immediate introduction into India’s Universal Immunization Programme (UIP) and opening it up for sourcing by low- and middle-income countries with GAVI support.

Dr. Bhan with ROTAVAC® partners at the scientific dissemination/press conference post successful completion of the ROTAVAC® Phase 3 clinical trial. Photo: PATH/ K.A. Balaji

Dr. Bhan with ROTAVAC® partners following the successful completion of the ROTAVAC® Phase 3 clinical trial. Photo: PATH/ K.A. Balaji

The introduction of the vaccine in India’s UIP is a milestone in the fight against rotavirus diarrhoea which causes ~40,000 deaths and many more hospitalizations among children under 5 five years of age. The rotavirus vaccine roll-out which has now been completed across India in record time is expected to transform the face of vaccination for diarrhoea in India. The vaccine has significantly lowered the cost of vaccination. A three-dose vaccination course of ROTAVAC® vaccine and another Indian rotavirus vaccine subsequently licensed costs just $2.5 as compared to the two other WHO-approved vaccines available in the market which cost around $35 per course.

It was Dr. Bhan’s passionate efforts that uniquely brought together the Indian government, international organisations, the non-profit sector, and private players to build this vaccine. The Indo US Vaccine Action Program (VAP) which was a bilateral funding mechanism between the governments of India and USA provided the initial funding, leading to the development of pilot vaccine lots. PATH came on board in early 2001 after a grant from the Bill & Melinda Gates Foundation and formalized a partnership structure with various stakeholders.

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Dr. Bhan with all the ROTAVAC® partners. Photo: PATH

The partners included the Government of India’s Department of Biotechnology, Society for Applied Studies, Bharat Biotech, Christian Medical College Vellore, KEM Hospital Research Centre, Translational Health Science and Technology Institute, the US National Institutes of Health, the US Centers for Disease Control and Prevention, Stanford University School of Medicine and PATH. Funding support for the partnership was provided by the Bill & Melinda Gates Foundation, the Research Council of Norway and the Department of Biotechnology.

The collaboration witnessed for the development of the vaccine was one of its kind with Dr. Bhan as the linchpin, driving the project ahead and managing the challenge of dealing with multiple stakeholders with an ease that only he could pull off. He had a genius for creating sustainable partnerships and bringing together various unusual and often competitive stakeholders in unique collaboration models to address complex problems. He was equally at ease in working with the private sector as he was with government systems and always seemed to come up with creative and simple solutions to seemingly impossible problems.

As the Secretary of the Department of Biotechnology, he is remembered for his varied contributions and initiatives to help the biotech sector grow in India. Some of the path breaking initiatives he heralded include the creation of the Translational Health Science Technology Institute (THSTI) to quickly translate research into usable products for wider benefit and the Biotechnology Industry Research Assistance Council (BIRAC) to help the biotech industry in India quickly access government support and research grants with minimal red tape.

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Dr. Bhan at a press conference to announce WHO prequalification for ROTAVAC®. Photo: PATH/ K.A. Balaji

PATH was associated with Dr Bhan in different capacities for close to twenty years. I joined PATH in 2000 and have had the privilege of working closely with him. The development of a new vaccine, clinical trials and licensing is a long and arduous process that often takes decades of a researcher’s lifetime testing their motivation to continue. But Dr. Bhan was different. His perseverance, passion and dedication for an impactful contribution to public health needed no additional motivation.

Despite his senior position, he was readily available to guide the project teams in all aspects of the monumental ROTAVAC® Phase III clinical trial, including clinical trial site selection, setting up a laboratory at THSTI and plugging any funding shortfalls through funding support from the Department of Biotechnology. Running a complex clinical trial in India is not easy but he saw the project through numerous roadblocks encountered along the way and ensured the resounding success of the project giving India a vaccine that was much needed.

He can also be rightly called as a messiah of children. He played a leadership role in promoting primary health care for children in rural India during the last two decades. His efforts made it possible to bring fruits of science and technology to national programs for children. He provided advocacy and leadership to many programs in India including promotion of oral rehydration therapy, micronutrient supplementation, introduction of new vaccines and providing greater coverage with existing ones. He played an instrumental role in bringing different stakeholders together for the cause of child health in India.

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Dr. Bhan with honourable S. Jaipal Reddy, the then minister of Ministry of Science and Technology. Dr. Bhan was felicitated by him for his contributions. Photo: PATH/ K.A. Balaji

Dr. Bhan was always cheerful, energetic, accessible and humble. Many a times, the project teams would sit in his office and discuss various issues till very late into the evening. I was deeply influenced by his energy levels and enthusiasm. He was always passionate about discussing new ideas. The few times I was lucky enough to travel with him on project related work, I never saw him tired. I saw him juggling his many responsibilities that came with his position effortlessly while still being very attentive and responsive to our project’s needs. Being young and just starting off in my career at that time, his multi-faceted persona and leadership inspired me deeply.

I feel fortunate that I got the opportunity to interact with him on a few non-vaccine projects as well. As the lone team member of PATH’s Ultra Rice project in its early days, I interacted with Dr Bhan who was also deeply committed to nutrition related issues. He saw great potential in Ultra Rice as a tool to address malnutrition and readily supported us in entering into an MoU with the Department of Biotechnology. He also helped us steer through some of the regulatory challenges initially. He supported us with convening meetings of then Food Safety Regulators and midday meal commissioners of various states to discuss the inclusion of rice in the food fortification category and mid-day meals respectively.

When I think of Dr. Bhan, I think of a famous saying, “Leadership is not a position or a title. It is example and action.” He was always passionate about making India self-reliant in scientific research and product development while at the same time was very receptive to international collaborations that would help Indian science grow.

Dr Bhan will always be fondly remembered as a true visionary who paved a remarkable path for India’s scientific community. His relentless passion and unparalleled contributions in the domain of public health leaves behind a legacy that will continue to inspire me and many others and help to create public health champions across the globe.