Reducing compliance burden in higher education

 Minimizing forms and procedures with a view to improve compliance and facilitate ease of doing business in higher education institutions both internally and externally through an integrated and well-coordinated single window system is the need of the hour

Early this year Department for Promotion of Industry and Internal Trade under the Union Ministry of Commerce and Industry (DPIIT) was entrusted to act as a nodal department for coordinating the exercise of minimizing the compliance burden on industry as well as on citizens with an aim to provide services in a time bound, transparent and predictable manner to the industry with a minimum human interface. Later Prime Minister of India desired that this should be adopted by all ministries, departments and states including the Ministry of Education in a mission mode and completed in time bound manner for better compliance management and ease of doing business.

Compliance management comprises of the actions and measures taken to facilitate ease of doing business at the higher education institutions both internally as well as externally with a view to reduce the burden of filling up forms and completing processes and thereby enhance adherence to norms, rules and regulations as well as minimize costs and inconvenience to all the stakeholders. Internal controls and measures govern all activities falling under the ambit of interface between university and departments as well as between departments and teachers and students whereas the external controls and measures govern the activities at the interface between university and regulators like UGC or Union Ministry of Education. Compliance management includes solutions mostly based on Information Communication Technology (ICT) and e-governance that are primarily aimed at simplifying the statutory procedures and making them less tedious and cumbersome both for the students and the Higher Education Institutions (HEIs) through an online single window system. Once an integrated and well-coordinated system is in place for complying with regulatory and statutory requirements for the students, teachers and higher education institutions, adherence to norms and instructions and fulfilment of requirements becomes a whole lot easier. It also minimizes the hazards of wrongdoings at the organizational level besides statutory non-compliance. Though developing a common understanding of compliance management is a real challenge in higher educational institutions, it provides an excellent opportunity to move a few steps closer towards excellence with improved performance and optimized outcomes. Implementing rules and regulations, internal or external, in letter and spirit is the responsibility of all stakeholders including teachers, non-teaching staff and students. 

Primary goal of measures aimed at reducing compliance burden is to harmonize, streamline, and wherever possible eliminate unnecessary forms, procedures and reporting requirements with a view to maximize and speed up compliance, integrate processes, increase fund utilization and optimize outcomes in teaching and research while ensuring accountability at higher education institutions.  These measures are also aimed at helping the universities to review their existing institutional policies to ensure that they are not adding unnecessary processes, procedures, burden and costs on themselves or on their teachers and students. At present universities are functioning under a great deal of command-and-control system and regulations from UGC/MoE, that includes burdensome documentation, recording and reporting requirements. One characteristic feature of regulations under the current system governing higher education institutions is that their eligibility for financial assistance under various central schemes is determined by the periodic ranking, accreditation and review by the government authorized accreditation agencies like NAAC, NIRF and NAB. However, the quantum of forms required to be filled and documents to be submitted for such accreditation and ranking is so huge that it deters many institutions from applying for the same in time thus reducing their compliance. Similarly the quantum of documentation and compliance by teachers required at various stages of their promotions is so enormous that many teachers end up applying too late for the same. All this needs too be changed radically by making online solutions and portals available to students, teachers as well as institutions for uploading their data from time to time wherefrom it can be extracted and integrated in real-time as and when needed. 

For managing workflows in higher education, system safety and security, accuracy, accountability and user-friendly interfaces are critical. HEIs deal with a large quantum of paperwork, documentation and requests that have to be managed on daily basis. As per Barta BZ et al (1995) computers can be used extensively for effective educational administration in workflow areas including general administration, pay roll and financial accounting, administration of student data, inventory management, maintenance of personnel records, library and information system etc. By automating the workflow around activities and functions like student registration, student admissions, selection of OE/GE courses under choice-based credit system, conduct of online classes, student information, time table, transport, examinations, performance, grades, hostels, security, maintenance of attendance, internal assessment, library, salary and expenses, registration and conduct of examinations, e-award system, e-transit modules, result compilation and declaration, re-checking and re-evaluation system, certificate distribution, issuance of transcripts, marks card printing, sms or text-based alert services, stream change or migration, e-tutorials and e-contents, online learning and open education resources etc, paper-based manual processes reduce considerably paving way for a more efficient and productive institutional workflow. It brings a lot of convenience and comfort to the students as well saving a lot of their precious time while enhancing compliance to norms and regulations. However, the need for submitting hard copies after applying or registering online should be minimized as that mars the very spirit and purpose of the entire automation exercise. And secondly all these systems should be integrated and well connected with each other so that the information uploaded at one system should be visible and retrieved everywhere else. In this regard, progress already made and ground gained under NAD (National Academic Depository) needs to be further exploited and scaled up. 

Attempts need to be made to make single window management system available for both internal and external controls of the higher education institutions. Homepage of the institutional website must provide links to all online services and tools available that must be clearly visible as well as easily accessible. Secondly data uploaded by departments and teachers using only one Unique Institutional or Universal ID through Internal Quality Assurance or IT wing must be corroborated and integrated with all other sections dealing with examination, recruitment, accounts, research and academics. Data must be consolidated in real-time and the same must be automatically used as and when required for promotions, reconciliation, appraisals, assessment, annual reports etc without the need to submit any hard copies thus avoiding duplication, repetition, deficiencies, discrepancies and inaccuracies in the data submitted. Need for uploading the same data for each wing separately at different times must be completely done away with. Similarly the UGC or Union Ministry of Education must develop a portal at the central level where higher education institutions can upload their data from time to time and the same gets consolidated and utilized for different purposes in real time as and when needed for activities like accreditation, assessment and evaluation, ranking, project allocation, funding, grant of positions, programmes and centres. Phrases such as Education Management Information Systems (EMIS) or Management Information System (MIS) have been typically used for integrating information from different universities to consolidate them on a common operating platform for analysis or data aggregation purposes. In order to achieve the objective of a paperless university there is need for complete automation of the file management system, accounts management, online payment gateways, online budget management system, class schedule approvals, curriculum peer reviews, faculty travel and deputation requests, financial aid requests, grant proposal processes, internship applications, staff and faculty onboarding besides vendor approvals. 

Processes and procedures involved in research too need to be simplified and automated through a well-integrated Research Management System that provides all services in a seamless manner including online synopsis submission, minutes of DRC meeting online, allocation of research guide, submission of synopsis to BORS, synopsis approval (or rejection) by the BORS, half-yearly progress report submission, online thesis submission, approval by research guide, submission to Head of the Department, academic clearance by Dean Research, award of degree, publication of result notification, online accounting system for research projects, online system for M.Phil. and Ph.D. registration, assessment and award. A single window system in research will ensure accomplishment of research projects and completion of research degrees well in time thus avoiding delays and unnecessary hassles for the scholars as well as principal investigators. It will reduce red tape-ism too that acts as a great deterrent for many a promising researchers in seeking grants from funding agencies for executing their research projects.

Higher Education Institutions need cost-effective, IT-based, online solutions that allow for generation, use and re-use of customized, user-friendly, automated processes that can eliminate redundancies, delays and non-compliance and consolidate student as well as staff services into a single portal, provide a better service experience, limit or completely replace manual and paper-based processes for students and staff, centralize and streamline the review and approval process for requests, track and summarize requests that need to be routed through departments before final approval, meet statutory and regulatory requirements and improve internal controls. With workflow automation, we can streamline workflow in critical, student-facing departments like students welfare, admissions, registration, examination and academic records. An efficient and fully functional e-governance system in higher education will enable various stakeholders to achieve an improved operational efficiency in various key processes like submission of grant requests, disbursement of funds, utilization certificates, approval processes, ranking and accreditation, feedback mechanism etc. Our universities need to evolve by providing their students a centralized, user-friendly portal to submit requests and provide information, while providing teaching and non-teaching staff with powerful, automated workflow and request handling tools. By replacing slow, manual processes with the automated workflow universities can move students through their processes faster, improving their experience and compliance with the standards at the same time.

Importance of Faculty Induction Programmes in Higher Education

 Newly appointed teachers of the higher education system need well-designed induction training programmes at the onset of their career for better handling of classroom situations and students, improved curricular transactions and effective teaching learning processes 

Teachers are the pivots of our higher education system and therefore we need to provide them adequate opportunities within the framework of knowledge society for their professional, personality, pedagogical and career development. Inbuilt mechanisms need to be evolved for their probationary apprenticeship as well as continuing education in order to aid them in building their capacities and thereby help them contribute substantially and significantly towards the body corporate of their higher education institutions that can in turn lead to their institutional and organizational development. Conventionally college or university teachers are believed to learn their art of teaching either by actively emulating outstanding role models such as their own teachers or senior colleagues or by self-learning through their own experiences and efforts. However, in the current age of information technology it may no longer be prudent to expect newly appointed teachers to acquire the art of teaching entirely by emulating their peers and seniors either actively or passively. Well-designed induction training programmes need to be offered at the onset of their career for better handling of classroom situations, improved curricular transactions and effective teaching learning processes. 

Furthermore, there has been a knowledge explosion of late in each and every discipline owing to an easy accessibility to information resources through ICT. College and university teachers too need to continuously update their knowledge, skills and competencies in their own areas of expertise, or simply run the risk of turning redundant in a short span of time. While the really motivated and zealous teachers use their own resources to keep themselves abreast of new knowledge and resources and to train themselves in the latest processes, pedagogies and techniques of teaching, it is imperative to make systematic, comprehensive and well-organized induction and orientation programmes available for the large number of new entrants in teaching at the college and university level. This assumes even greater importance in light of the fact that unlike doctors, bureaucrats and police officers no internship or probationary training is imparted to teachers before inducting them into the actual profession of teaching. While most of them know their own subject very well, some of them find themselves at loggerheads when it comes to teaching and handling different kinds of classroom situations and students. Therefore teachers need to have a fair understanding of the psychology, philosophy and technology of teaching apart from their own area of specialization in order to manage varied behaviours, personalities, attitudes and outlooks of students in their classrooms well. 

In order to fill this void, University Grants Commission, New Delhi has formulated Guru Dakshta Faculty Induction Programme (FIP) of one month duration in November, 2019 and made it compulsory for newly appointed teachers of colleges and universities during the first year of their appointment. FIP is primarily aimed at familiarising the newly appointed teachers of higher education sector with their roles and responsibilities and orient them towards various generic aspects of teaching learning processes, instructional methodologies, assessment and evaluation techniques, besides equipping them with the knowledge of university rules and regulations, fundamentals of hierarchy and administration of higher education institutions. FIP is meant to introduce the new entrants with the structure, functioning, organization and governance in higher education institutions; help them explore pedagogical processes including curricular transactions, instructional planning, teaching methods, classroom management, use of resources and motivate them to recognise the importance of self-development, socio-emotional development of students and of nurturing ethics and values in higher education. 

As per UGC guidelines, the pedagogy used in the Faculty Induction Programme has to reflect participant-centered, inclusive, outcome-based, active learning with adequate use of technology. Approaches that new teachers are being encouraged to use in their classrooms have to be demonstrated during the FIP as well. Teaching pedagogy of the programme has to be based on a combination of peer-facilitated, expert-led, self-learning processes that include discussions, debate and group reflection while connecting key concepts and ideas to the everyday classroom teaching. Participants have to be actively encouraged to reflect on and share their own understanding, questions, practice and experience. Collaborative learning methods like jigsaw, think-pair-share along with role plays and demonstration have to be used during the programme. Resource materials relevant to specific modules have to be shared in advance with the participants as part of the self-learning process in a flipped classroom situation and the book excerpts, articles, policy documents, case studies and video/film clippings shall be an important source of material to be used by them during the training. 

UGC-Human Resource Development Centre of the University of Kashmir conducted its first Guru Dakshta Faculty Induction Programme from March 2 to 29 that was attended by 30 newly appointed Assistant Professors of colleges and universities from within and outside J&K. A total of 96 sessions spread over 24 working days comprising of 144 contact hours @ six hours per day were conducted during the programme. Eminent resource persons from within and outside J&K and abroad were invited to deliver talks on diverse topics and interact with the participants of the course. To begin with a session was held on lecture preparation, delivery techniques and current trends in teaching followed by sessions on the fundamentals of teaching and learning process, online teaching during COVID-19 era: prospects and challenges and the ICT tools for teachers in higher education. Teachers were familiarized with transaction styles, personality and behaviours in varied classroom situations. Some other sessions related to teaching pedagogies included talks on outcome-based education, innovative and emerging teaching pedagogies, teaching and education in a symbiotic relationship with each other; choice-based credit system, SWAYAM and MOOCs platforms in teaching. This was followed by a couple of sessions on scientific publishing with special reference to journal metrics and indexing; plagiarism and copyright issues in teaching and research. 

Besides focussing on teaching equal attention was paid towards issues related to research and several sessions on fundamentals, objectives and ordeals in research; research designs; qualitative research methods and research ethics were also arranged. Awareness was created among the participants about service and leave rules; total quality management in higher education; taxation laws and financial management besides educational strategies for youth empowerment. Issues related to governance in higher education: role of stakeholders; structure of governance in a university system; National Education Policy-2020 and institutional development; Higher Education Commission of India and UGC Regulations 2018 were also covered. Participants were sufficiently sensitized regarding the importance of gender studies; innovation, incubation and entrepreneurship development through patents; interface between science and society; data sciences and machine learning for teachers; importance of mentoring; importance of folklore, culture and heritage studies in higher education; environmental issues of societal importance; state of economy in J&K; mental health issues for teachers; role of teachers in understanding personality disorders among young learners. 

In their presentations emphasis was laid by the resource persons on inculcating professionalism, embracing ethics, exhibiting enthusiasm, displaying empathy and espousing resourcefulness in their teaching and research activities. Teachers were urged to be dependable, ethical, positive, respectful, to build a team and to be the best in their conduct as well as content and delivery. They were advised to be passionate, inspiring role models for their students and motivate them to excel in life through creative and analytical thinking, hard work, dedication and commitment towards learning. They were told that the teachers and students must not only learn to know and learn to be but also learn to do and learn to live together. A teacher must evolve and emerge as a friend, philosopher, guide, planner, disciplinarian, manager, counsellor, facilitator, care-giver, coordinator, communicator, fatherly figure and an educator but not as a tutor who promotes rote learning.  Participants were urged by the experts to flip their classroom teaching by flipping the Bloom’s Taxonomy and supply the resource material even before the class to the students with a view to facilitate their understanding and memorisation of the subject; during the class focus only on analysing and applying what has been learnt at home and after the class undertake evaluation and creative tasks. This is how learning would become practical and meaningful and lead to application of the knowledge gained. 

On the whole this month-long course was rated as highly informative, interesting, refreshing, enlightening and beneficial by the participants wherein they gained new insights and perspectives about teaching and learning process and got an opportunity to update their knowledge, competencies, skills and proficiency in teaching as well as research and also helped them enhance their motivation, efficiency and aptitude in their own areas of specialization. As part of their evaluation participants wrote book reviews, delivered seminar presentations, devised curriculum for skill-based courses in their respective specializations and appeared in MCQ-based written test towards the end of their course wherein they performed well and successfully completed the course. Online attendance-cum-feedback of the participants was collected for each and every session as well as for the whole course. Besides all the participants were given an opportunity to moderate at least one session each and act as rapporteurs preparing as well as presenting reports of the proceedings of their respective sessions. First FIP of the UGC-HRDC, University of Kashmir proved to be a great learning experience for the participants and the organizers as well. 

(Author was the Course Coordinator of Guru Dakshta Faculty Induction Programme organized by UGC-HRDC, University of Kashmir)

Rise of the Superbugs

 Measures need to be taken at international, national, community, hospital and individual level by healthcare workers including doctors, nurses, pharmacists and the patients as well in order to control the problem of antimicrobial resistance effectively in a time-bound manner. 

Alexander Fleming known as the “Father of Antibiotics” while receiving Nobel Prize for the discovery of Penicillin in 1945 had forecasted in his acceptance speech, “But I would like to sound one note of warning the time may come when penicillin can be bought by anyone in the shops. Then there is the danger that the ignorant man may easily underdose himself and by exposing his microbes to non‐lethal quantities of the drug and make them resistant”. Today humanity is witnessing his golden words turning into a harsh and bitter reality with under-, over- and misuse of antimicrobials leading to the emergence of resistance among bacteria and other micro-organisms. Day is not far when a minor injury, disease or surgery could result into the death of a person as a result of untreated infection due to antimicrobial resistance (AMR). Currently, at least 700,000 people die each year due to drug-resistant diseases, including 230,000 people who die from multidrug-resistant tuberculosis (WHO, 2019). British government appointed antimicrobial resistance review committee chairman Jim O’Neil predicted in 2016 that by the year 2050 there could be an estimated 10 million deaths annually as a result of AMR and it could cost the world economy a whopping 100 trillion dollars. An ever-growing list of infections such as pneumonia, tuberculosis, systemic infections and gonorrhoea are becoming harder and sometimes impossible to treat as antimicrobials continue to become less effective. Resistance has also rapidly emerged to sulphonamides, penicillins, tetracyclines, macrolides, fluoroquinolones and cephalosporins. 

Though some critics term these figures projected by Jim O’Neil as exaggerated, fact of the matter is that as per World Health Organization (WHO, 2020) high rates of resistance against antibiotics frequently used to treat urinary tract infections, sepsis, sexually transmitted infections and some forms of diarrhoea have already been reported world-wide, indicating that we are steadily running out of effective antibiotics. For instance, the rate of resistance to Ciprofloxacin, an antibiotic commonly used to treat urinary tract infections has increased from 8.4% to 92.9% for Escherichia coli and from 4.1% to 79.4% for Klebsiella pneumoniae in countries reporting to the Global Antimicrobial Resistance and Use Surveillance System (GLASS). WHO-GLASS has further reported that the resistance in Klebsiella pneumoniae, that can cause life-threatening infections, to the last resort treatment i.e., carbapenem antibiotics has spread to all regions of the world. K. pneumoniae is a major cause of hospital-acquired infections such as pneumonia, bloodstream infections and infections among newborn and intensive-care unit patients. Colistin is the only last resort treatment for the life-threatening infections caused by carbapenem resistant Enterobacteriaceae i.e., E. coli, Klebsiella, etc. However, astonishingly bacteria resistant to colistin have also been detected in several countries and regions, causing infections for which there is no effective antibiotic treatment available at present (WHO, 2019). Thus the world is fast heading towards what some people call as ‘antibiotic apocalypse’ and others term as ‘post-antibiotic era’ as a fall-out of multi-drug resistant or pan-resistant micro-organisms known in common parlance as ‘superbugs’. Superbugs exhibit super-resistance and like super-computers and self-automated AI machines turn uncontrollably and unimaginably hostile, wreaking havoc to the ailing lot like tuberculosis patients suffering from multi-drug resistant, extensively drug resistant and totally drug resistant forms of tuberculosis. 

Need of the hour is to take adequate prevention, management and control measures well in time to stop the spread of resistance among microbes though many scientists believe it to be an evolutionary process wherein micro-organisms are believed to mutate to resistant forms as a result of natural selection and environmental survival pressure created by antibiotics or the constrained environment. Intrinsic or acquired mutations allow them to survive and live on to reproduce. Then they pass this trait to their offsprings, which would be a completely resistant generation. Bacteria are remarkably adaptable organisms with an innate ability to circumvent damage if exposed to a toxic environment (Floris et al, 2020). Since the development of the first antibiotic less than a century ago, there has been an exponential growth in antimicrobial resistance that is disproportionate to the rate at which antibiotics are introduced. In 2019 WHO identified 32 antibiotics in clinical development that address the WHO list of priority pathogens, of which only six were classified as innovative. Since 1990, only three novel-class antibiotics have been launched (pleuromutilins, lipoglycopeptides, and oxazolidinones), although many derivatives of older classes were also launched (Baker et al, 2018). 

WHO has declared that AMR is one of the top 10 global public health threats facing humanity. It requires urgent multisectoral and multi-dimensional action in order to achieve the United Nations Sustainable Development Goals (SDGs). Superbugs are omnipresent in the biosphere Continued resistance is rapidly eliminating treatment options for patients, and the cost burden to treat a multidrug-resistant infection is steadily climbing, reaching more than $2.2 billion annually in the United States.  Universally, the market consumption rate of antibiotics is assessed to range from 0.1 to 0.2 million tons yearly (Wise, 2002). Antibiotics are extensively used in medical, veterinary, and agricultural platforms for therapeutic, prophylactic, metaphylactic and growth-promoting purposes. The overall quantity of antibiotics used worldwide in agriculture is estimated to range between 63,000 and 240,000 tons, with beta‐lactam antibiotics like penicillins, cephalosporins, and carbapenems being the largest group of antibiotics consumed (50%–70%) by humans (Kumar & Pal, 2018). 

Many strategies for avoiding, inhibiting, or bypassing resistance mechanisms in pathogens have been attempted. The most notable successes in such endeavors have been with the β-lactam antibiotics. Clavulanic acid and related compounds are potent inhibitors of β-lactamase enzymes and are frequently used in combination with the β-lactam antibiotics. These combinations have been highly effective but bacteria have found a way to outsmart us: a number of β-lactamases that are refractory to inhibition by clavulanate have appeared. To date, research to extend this approach to other classes of antibiotics has not been successful (Davies & Davies, 2010). Antibiotic resistance has been found in most bacteria, but several bacteria are particularly problematic and are becoming common among hospital-acquired infections that include Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacteriaceae commonly referred to as ESKAPE pathogens (Floris et al, 2020). In 2017, the WHO published a list of bacteria where new antibiotics to tackle them are needed urgently and grouped them according to their priority as critical, high and medium, with a view to encourage research and development of new antibiotics. 

AMR can be overcome to a large extent by referring to nature to develop naturally derived agents with antibacterial activity on novel targets such as bacteriophages, Odilorhabdins (ODLs), peptidic benzimidazoles, quorum sensing (QS) inhibitors and metal-based antibacterial agents and by deactivating the mechanism of resistance, like the action of the β-lactamase inhibitor antibiotic adjuvants (Breijyeh et al, 2020). Strategies relying on phage therapy, probiotics, CRISPR technology, faecal transplantation and host immune response biomarkers are also being explored as novel approached to combat AMR. Innovative vaccine technologies, such as reverse vaccinology, novel adjuvants, and rationally designed bacterial outer membrane vesicles, together with progress in polysaccharide conjugation and antigen design, have the potential to boost the development of vaccines targeting several classes of multidrug-resistant bacteria (Das et al, 2017). Furthermore, new approaches to deliver small-molecule anti-bacterials into bacteria, such as hijacking active uptake pathways and potentiator approaches, along with a focus on alternative modalities, such as targeting host factors, blocking bacterial virulence factors, monoclonal antibodies, and microbiome interventions, all have a significant potential to counter AMR (Baker et al, 2018). 

Unless and until adequate prevention and control measures are not adopted in a concerted fashion by all the stakeholders, it is not possible to combat AMR through novel and innovative approaches. A mix of conventional and novel approaches alone is going to yield best results. Measures need to be taken at international, national, community, hospital level as well as at individual level by healthcare workers including doctors, nurses, pharmacists and by the patients in order to control the problem of AMR effectively. All stakeholders need to join hands and act in an integrated and collaborative manner complementing and supplementing each other in their efforts towards preventing and controlling AMR. All our hospitals need to devise their own infection control and antibiotic use policies besides framing standard treatment guidelines for infectious diseases and constituting Drugs and Therapeutics Committees and formulating Hospital Formularies (Geer, 2017). There is a need to conduct culture tests for determining antimicrobial sensitivity first and then only prescribing antibiotics. Rampant sale and use of antimicrobial drugs that have been listed and notified in 2013 under Schedule H1 of the Drugs and Cosmetics Act, over-the-counter sans any prescriptions written by qualified physicians and their indiscriminate sale by unqualified pharmacists at retail sale outlets need to be curbed with tough regulations and strict law enforcement. Need of the hour is to implement this provision strictly on war-footing basis failing which it will be impossible to avert AMR. Indiscriminate sale and use of antibiotics cannot be taken lightly anymore. Jammu and Kashmir government must come up with a robust and comprehensive action plan of its own for the containment of AMR as soon as possible. Other measures that the government needs to take for the prevention and control of AMR have been enumerated in another article of mine published in 2017 on “Averting Antibiotic Apocalypse in J&K”.

Scientific progress - hallmark of a dynamic society

 Fostering a creative mindset and nurturing academic freedom can spur innovations in the curriculum that in turn will churn out graduates with innovative ideas and ultimately result in substantial scientific progress in terms of innovations and inventions 

Pace of progess made in science and technology is the hallmark of a dynamic and vibrant society as twenty first century belongs to the science and technology and any nation that fails to keep pace with latest trends and recent advances made at the global level in this sector will draw a flak and eventually be despised as an unenterprising and regressive nation. Such a nation will also face a lot of difficulties in meeting with the needs, demands and challenges thrown by the potential threats and dangers of the twenty first century including human existential threats, food, water and fuel scarcity threats, cyber security and climate change threats, threats posed by lab designed viruses and bacteria and nuclear threats. Therefore there is need to prepare vision documents and perspective plans at the national as well as regional level in which long range targets are set in advance for a period of 10, 20 or 25 years for making some tangible and time bound progress in the field of science and technology while at the same time promoting innovations and inventions.

Progress made in science and technology by any nation at present can be assessed by the quantum of adoption of innovations and inventions made at the global level, degree of innovations and inventions contributed by that nation to the world and the level and quality of education and awareness among its citizens regarding some of the most burning and contemporary issues in science and technology. Former Principal Scientific Advisor to the Govt. of India R Chidambaram has in his Current Science article added one more dimension to this kind of evaluation by writing that “scientific research publications are one of the quantitative measures for the basic research activity in a country” and that “the root cause for stagnancy in the number of research publications from India seems related to the fact that talented and bright young students have not been opting for careers in science in recent years”. In another article he has emphasized that “the science and technology foresight involves forecasting of possible futures, taking into account existent as well as emerging technologies, with the objective of achieving the maximum economic, social and security benefits”.

In order to stay relevant and be counted in the modern world any nation has to strike a fine and delicate balance between being a producer and a consumer of the fruits of science and technology.  Nations that are only good at consuming and reaping the benefits of science and technology and are not performing fairly well at producing the innovative products for others will ultimately be thrown out of the race towards scientific progress and development and they will have to bear with little or no opportunities to earn sizeable revenue from the global markets. This will relegate them to the back benches and they will eventually lose all their influence as well as opportunities of emerging as global leaders. In order to avoid any such situation developing nations will have to undertake a major overhaul of their S&T curriculum, training, innovation incubation, entrepreneurship development and the whole education system at school, secondary and higher education levels.

Education and awareness about emerging areas in S&T

Creating awareness and imparting education about emerging areas in science and technology is the first step towards planting a seed that will eventually grow into a tree and bear sweet fruits for all to relish. Education and awareness needs to be enhanced about contemporary emerging areas in science and technology including artificial intelligence,  cloud computing, data analytics, robotics, space technology, nanotechnology, biotechnology and molecular biology, stem cell technology, gene therapy, 3D printing, quantum computing, biodiversity and ecology, point-of-care testing, nuclear and bio-physics, internet-of-things, micro-electrical mechanical systems, crypto-currencies, cancer vaccines, genetically modified foods, cell culture and in-vitro fertilization etc. There is a need to enhance the knowledge-base, training, skills, competencies, expertise, interest and familiarization in these areas among the youth. Once they are sensitized about all important aspects of these areas they can pursue higher education in them and acquire sufficient academic acumen and technical prowess to forge innovative solutions in these areas. This will help generate a technically competent workforce ready to venture into these areas and produce tangible results. Curricular updation at a large scale at school, college and university levels shall be required for meeting this challenge of change.

Adopting global innovations in our day-to-day life

Adopting global innovations and inventions in our day-to-day life is as important as knowing about them. Apart from knowledge, data is going to be the new capital in the twenty first century.  World is heading towards a mad and bitter race for data in the coming years. We need to march ahead in tandem with rest of the world lest we shall lag behind and be overstepped by other nations in this race. It is said that burgeoning consumerism leads to a faster adoption of the breakthrough innovations. As per William Pollard, “Learning and innovation go hand in hand; the arrogance of success is to think that what you did yesterday will be sufficient for tomorrow”. Greek philosopher, Hiraclitus says, “The only constant in life is change”. Change calls for innovation and innovation leads to progress. “Without change there is no innovation, creativity, or incentive for improvement. Those who initiate change will have a better opportunity to manage the change that is inevitable”, William Pollard has said. Political will of the government for adopting global innovations is of key importance. Unless there is political will no tangible innovation and progress in S&T is practically possible. As per Bill Gates, “Governments will always play a huge part in solving big problems. They set public policy and are uniquely able to provide the resources to make sure solutions reach everyone who needs them. They also fund basic research, which is a crucial component of the innovation that improves life for everyone”. 

Contributing our bit of innovations and inventions 

While it is important to gain sufficient knowledge and know-how about innovations and inventions made globally and also to adopt them to every possible extent in our day-to-day life, it is equally important to keep contributing our share of innovations and inventions on persistent basis with a view to stay technologically relevant as well as reliable in the international arena. Our academic and research institutions need to innovate themselves first in order to be capable and competent to contribute innovations and inventions that are acceptable and buyable in the global markets. Peace and stability as well as unity and economic strength of a nation assumes utmost importance in being able to come up with innovative solutions to the problems and challenges thrown by twenty first century. Nations facing internal strife, discord and distress socially, politically and economically will find it increasingly difficult to compete in the global innovations market. A creative mindset and liberal ideology as well as academic freedom alone can spur innovations in the curriculum that in turn will churn out graduates with innovative ideas and ultimately result in substantial noteworthy scientific innovations and inventions. 

Global scientific community can work in tandem across cultures and nations, bridging political divides to encourage innovations and engineer inventions all across the world. In order to promote science education and scientific temper among our progeny at school, college and university levels, we need to have students eager to investigate the wonders of the natural world, teachers steeped in scientific knowledge and masterful at guiding students' investigations, parents and school administrators who value, expect and support standards-based science education, leaders in business and government who understand the importance of science education for all citizens. Scientific temper is considered to be the best answer to ignorance, superstition and arrogance. A citizen without scientific literacy can have no basis for discerning the valuable from the worthless. One who is scientific literate is able to critically interpret, analyze and evaluate claims and not just believe the hearsay or go by the common public perception. He knows how to research relevant data, examine evidence and draw appropriate conclusions because theories are judged by results. Sincere, dedicated and collective efforts alone on part of all these stake-holders can get us rid of the ills that are plaguing our understanding of, adoption and contributions to science and technology. 

Coronavirus disease outbreak has exposed many chinks in our armour. It has virtually caught the whole world napping in terms of our preparedness to combat a crisis of this magnitude and mange its consequences well. Higher educational and health institutions as well as research centres in developing countries like India have not come out with sufficient and substantial new knowledge, guidance, resources, policy papers or blueprints to counter the economic, sociological, psychological, medical, commercial, humanitarian and health-related challenges posed by the pandemic. We have turned into consumers of knowledge and resources emerging from rest of the developed world necessary for tackling its fall-outs. Therefore we need to learn this bitter lesson from the ongoing crisis and prepare for more such challenges and other possible, similar disasters in the coming decades. Road to our preparedness towards such unprecedented situations leads through an impressive progress in Science and Technology alone.

Innovating science and technology education

 In light of fast changing global scenario with respect to science and technology, it is high time that we upgrade our science curricula and innovate our science and technology education in order to meet the emerging global challenges. 

Substantial progress in Science and Technology is the key to sustained development of any nation in the twenty first century. Keeping in view the contemporary developments in Science and Technology at the international level, Indian universities too need to enunciate a comprehensive policy framework to synergize science, technology and innovation in order to achieve faster, sustainable and inclusive growth and foster, promote, sustain cultivation of science, scientific temper and scientific research in all spheres with special emphasis on innovation that is the essential driver and sustainer of socio-economic transformation. There is need to promote science and technology education drastically in our universities in order to create favourable conditions and enabling environment for innovations to occur. Faculty development and capacity building in the area of science and technology assumes prime importance in fostering a scientific temper among the student community. A well equipped and skilled teacher alone can steer his students towards the inquisitive and fascinating world of science and technology. 

It was with these very objectives that the Refresher Course in Science was organized by the UGC-Human Resource Development Centre, University of Kashmir from January 2 to 15, 2021 for college and university teachers in accordance with UGC norms. Idea was to enhance the knowledge, skills, competencies and understanding of teachers about various critical areas of modern science and technology. Course was inaugurated on January 2^nd by Prof. Talat Ahmad, Vice-Chancellor, University of Kashmir in an impressive online session that was chaired by him as the Chief Guest whereas Registrar, University of Kashmir, Dr. Nisar Ahmad Mir was the Guest of Honour at this occasion. While emphasizing upon the importance of science and technology education Prof. Talat Ahmad underscored the need to update the knowledge-base and skill sets of teachers working in higher education sector in science and technology as the future belongs to this very discipline and we need to keep pace with the rapid developments taking place at the global level in this arena.  

A total of 76 college and university teachers both from within and outside J&K attended the course for a period of twelve days during which a total of 24 lead lectures were delivered by renowned resource persons in science besides a total of 76 participant presentations. All the sessions were highly interactive that generated a lot of debate on various issues of high importance. In spite of chilling winter, frequent power breakdowns due to heavy snowfall, slow internet speed this academic journey continued uninterrupted and this science festival of two weeks was successfully completed. At the valedictory session of the course that was held on January 15^th, 2021, Prof. A. G. Ahangar, Director and EOSG, SKIMS, Srinagar was the Chief Guest whereas Prof. Mohi-Ud-Din Sangmi, Dean College Development Council, University of Kashmir was the Guest of Honour. Session was also attended by incharge Director, UGC-HRDC, University of Kashmir, Prof. Mushtaq Ahmad Darzi besides all the participants of the course. 

Some of the most burning issues that were discussed at length during the course by renowned resource persons of science include COVID-19 vaccination, particulate pollution in the Kashmir valley, ecology and long-term ecological research, nanoscience, artificial intelligence; fundamentals, objectives and ordeals of research, research methodology and research ethics, antimicrobial resistance, importance of patents, innovation incubation and technopreneurship development, greatest feats of organized science, language of the universe, rise of Himalayas, lifestyle disorders, responsible use of medicines; chemistry, clinicians and cure; climate change-issues and challenges; gender Audit, gender equality and gender mainstreaming; Nobel prize controversies, importance of mental health amid COVID-19 pandemic, vocationalization of education and centrality of proof in Mathematics. Main idea was to refresh the knowledge of participants about fundamentals of research and research methodology, importance of patents, scientific publishing, ethics in research and scientific publishing, significance of start-ups, innovation incubation and technopreneurship besides many other contemporary issues of global significance. 

Eminent resource persons who delivered their lead lectures during the course include Prof. Talat Ahmad, Prof. Mushtaq A. Siddiqi, Prof. M. S. Khuroo, Prof. Devesh Kumar Sinha, Prof. Anil Kumar Mishra, Prof. Parvaiz A. Koul, Prof. Shakil A. Romshoo, Prof. Nilofer Khan, Prof. M. Amin Sofi, Prof. Zafar A. Reshi, Prof. G. Mohiuddin Bhat, Prof. Farooq A. Masoodi, Prof. Syed Ziaur Rehman, Prof. Shariq R. Masoodi, Prof. M. Ashraf Ganie, Prof. Manzoor A. Malik, Prof. M. Ashraf Shah, Prof. S.M. Salim Khan, Prof. Arshad Hussain, Prof. M. A. Chisti, Prof. Fozia Qazi, Prof. Manjiri S. Gharat, Dr. Manzoor A. Shah and Dr. Manzoor A. Chachoo. 

Many other issues were covered during participant presentations some of which include bio-orthogonal chemistry, high temperature electrical transport and optical studies of nanoparticles, nanovaccines and COVID-19, dietary management of diabetes mellitus, molecular machines, carbon nanotubes in medicine and biology, economic importance of bacteria, aquatic macrophyte treatment systems, environmental impact of riverbed mining, ethno-medicinal uses of some wild plants of Kashmir Himalayas, geothermal energy, mobile technology with special emphasis on 5G technology network, gene therapy, tackling drug resistant tuberculosis, global solidarity, pollen allergy, ICT tools for teachers, global cooling and climate change, statistical physics, e-waste management, paleoclimate, wild life conservation efforts in J&K, scientific and research misconduct, cryosphere changes in J&K, whistlers and VLF waves, chemistry of snow flakes, genetically modified foods, environmental issues in an unequal world, e-resources, CRISPR/CAS editing of plants, depletion of ozone layer, disaster proneness of J&K etc. 

Several existential threats seem to be looming large on the human race and gaining momentum with each passing year in the twenty first century, some of whom include catastrophic climate change and collapse of ecosystems, artificial super-intelligence and the rise of robots, alarming threat of a nuclear warfare, threat of super-volcanic eruptions and devastating earthquakes, impacts of huge asteroids hitting hard upon the earth, biological and chemical warfare, pandemics, anti-microbial resistance and the emergence of incurable diseases. This is doubly aggravated by the threat of man-made disasters like manufactured, bio-engineered, bio-hazardous super-viruses and bacteria, nuclear terrorism, cyber crime, forest fires, satellite junk and outer-space warfare, water wars clubbed with alarming environmental break-down caused by a spike in carbon emissions, rapid melting of arctic ice, steady rise of global temperatures, erratic and extreme storms assailing coastlines etc. Under these evolving and challenging circumstances sufficient knowledge about these potential threats among educators could help explore sustainable solutions and armour to tackle them in their right earnest. Furthermore only a strong, collective, pooled and united effort at the global level could help us find solutions to these emerging threats to the existence of mankind on the face of earth. 

As per the world economic forum “world stands on the brink of a fourth industrial revolution that will fundamentally alter the way we live, work, and relate to one another. In its scale, scope, and complexity, the transformation will be unlike anything humankind has experienced before. We do not yet know just how it will unfold, but one thing is clear: the response to it must be integrated and comprehensive, involving all stakeholders of the global polity, from the public and private sectors to academia and civil society”. This lays direct focus upon the innovation and upgradation of our science and technology education incorporating and embracing modern technological breakthroughs like artificial intelligence, robotics, big data analytics, the Internet-of-Things, block chain revolution, autonomous vehicles, 3-D printing, nanotechnology, biotechnology, materials science, energy storage, and quantum computing. It is high time that we upgrade our curricula in sciences with a view to catch up with the global challenges.

Reducing pill burden of patients

 Adopting minimalist approaches in prescribing and use of medicines is not just a choice but a necessity in the wake of ever increasing pill burden and their adverse effects upon patients particularly among the elderly 

Over the past century modern medicines have proved to be the magic bullets for alleviating the sufferings of the ailing lot. Whenever human race was desperate to obtain some remedies for crippling diseases and disorders, modern medicine has come to its rescue and brought a sigh of great relief from their pain and discomfort. Discovery of medicaments has served as a life elixir and improved the quality of life of the human kind. Modern medicine that is being practiced today by our erudite allopathic physicians is based on scientific evidence that has evolved and emerged out of decades of painstaking research and clinical trials on human subjects in addition to pre-clinical testing making it the most reliable and credible source of relief in times of disease and distress. As long as evidence-based medicine is practiced there is no reason for anyone to unduly criticize or pick holes in it. However it needs to be borne in mind that all drugs have side effects even if they are rationally and reasonably prescribed to the patients making it necessary to monitor them persistently and restrict their use to the utmost extent possible besides avoiding all kinds of overuse of drugs. Moreover a high pill burden i.e., the total number of pills including tablets or capsules, that a person has to take on a regular basis, also increases hassles and efforts associated with that number like storing, organizing, consuming and understanding the various medications in one's regimen besides paying for them out of one’s pocket. 

Though with the addition of a multitude of drugs to the physician’s armamentarium over the past hundred years, treatment of many hitherto untreatable diseases has become possible, every progress has a price to pay as new drugs have led to a new group of diseases known as the iatrogenic diseases. Ironically these can also be called as the 'diseases of medical progress'. "Primum non nocere " - first of all be sure you do no harm - has long been a fundamental principle of the practice of medicine, devised by Hippocrates, who is considered as the father of modern medicine, way back in 460 BC. One of the greatest hazards in the use of modern medicines is their inherent toxicity and the dangers of drugs appear to be greater than ever before as a result of the immense growth in their availability and consumption worldwide. Whilst most consumers derive far more benefits than harm, a large proportion of patients experiences adverse drug reactions too from the use of medicines even at recommended doses and frequencies. For some patients, such undesirable effects are sufficiently severe to require hospitalization whereas a few of them even die. In view of unwanted effects of drugs, an American physician, poet, and polymath Oliver Wendell Homes has said that “If the whole materia medica (classical compendium of medicinally useful substances) could be sunk to the bottom of the sea, it would be all the better for mankind, and all the worse for the fishes”. Ancient Indian healer known for his pioneering contributions to Ayurveda besides compilation of the medical treatise entitled ‘Charaka Samhita’ has also stated that “even a strong poison can become an excellent medicine if used properly. On the other hand even the most useful drug can act like a poison if handled carelessly”. Therefore minimalizing the use of medicines is not just an option but a necessity since increasing pill burden particularly upon elderly patients is not only decreasing their adherence to their prescriptions but also telling adversely upon their trust and confidence in medicines. 

Polypharmacy, defined as the use of multiple drugs or more than that are medically necessary, is a growing health concern particularly for older patients. International research has shown that nearly 50% of elderly patients take one or more medications that are not medically necessary though multiple therapies are often needed among elderly patients owing to their several co-morbidities and only a small percentage of physicians may actually be resorting to polypharmacy that too during their private practice. Within tertiary level govt. health facilities a standard protocol of treatment is usually followed leaving little scope for needless prescribing of medicines. Nevertheless scientific research has clearly established a strong relationship between polypharmacy and negative clinical consequences. A retrospective cohort study found that polypharmacy was associated with an increased risk of taking a potentially inappropriate medication and an increased risk of outpatient visits besides hospitalization with an approximate 30% increase in medical costs. This necessitates the need for persistent deprescribing alongside prescribing of medicines. Both of them should go hand in hand, complement and supplement each other on regular basis so that the patient’s therapeutic regimen turns out to be well-tailored, customized and need-based in tune with his personalized requirements. Polypharmacy can significantly contribute towards what sociologists like Irving Zola, Peter Conrad and Thomas Szasz have in the 1970s described as “Medicalisation of the Society” that carries the dangers of unnecessary labeling, poor treatment decisions, iatrogenic illness, economic waste as well as opportunistic costs. 

Deprescribing on the other hand has been defined as the planned and supervised process of dose reduction or stopping of medication that might be causing harm, or no longer be beneficial to the patient. It is the process of tapering, stopping, discontinuing, or withdrawing drugs, with the goal of managing polypharmacy and improving clinical, economic and humanistic outcomes of the treatment on the basis of minimalist approaches that are purely guided by scientific evidence in addition to the clinical experience and judgment of the prescriber. Just like standard treatment guidelines are required to guide the medical community in choosing the most appropriate therapeutic regimen for a particular patient depending upon his needs, there is need for robust guides and algorithms for deprescribing too that are equally focused on when, why and how a medication needs to be stopped. Necessary guidelines for both prescribing and deprescribing  need to be devised, incorporated in the medical curriculum and made abundantly clear to the medical practitioners with a view to promote good decision-making and avoid inappropriate and unnecessary use of medicines. 

Though there is no denying the fact that modern medicine has turned out to be a panacea in liberating the suffering humanity from the torment of disease and affliction, it is a fact that at the end of the day most of the modern medicinal agents are pure chemicals bound to interfere with the natural biochemical and physiological process of the human body as a result of which minor or major undesirable events are bound to occur sooner or later. There is hardly any drug that doesn’t come with one or more such unwanted effects of varied nature and intensity. Some adverse effects are mild, some moderate, some severe and few even lethal. Their incidence or frequency also varies from very common to common (frequent), from uncommon (infrequent) to rare. Their time of occurrence can range from rapid to early (intermediate) to late and delayed. Therefore adverse drug events can range from mild to life threatening reactions resulting in inconvenience or serious morbidity and mortality besides being a significant financial burden on the society. However a silver lining in the dark clouds is that studies have found 95% of adverse drug reactions as definitely or possibly avoidable, whereas 63% have been reported to be possibly avoidable and only 28% as unavoidable. Need of the hour is to take concrete measures to avoid adverse drug reactions to the maximum extent possible. 

One way to reduce pill burden and related complexities is by giving fixed-dose combinations (FDC) of drugs. FDC is a drug that is a combination of two or more drugs in fixed proportions. A meta-analysis of research on this issue has found that non-compliance to medications decreased by 26% when people took fixed-dose combinations for conditions such as hypertension, HIV and tuberculosis. However fact of the matter is that a fixed-ratio combination is acceptable only when it meets the requirements of a defined population and when the combination has a proven advantage over a single compound administered separately in terms of therapeutic efficacy, synergistic effect, safety or compliance. In the year 2016, Govt. of India banned 344 fixed dose combination drugs, including several antibiotics and analgesics, saying that a panel of experts has found that these combinations lacked "therapeutic justification". FDCs do however have their own advantages as well as disadvantages that can be discussed separately. 

“In an era of many drug choices and the ability to individualize patient care as never before, the fixed combinations limit clinicians’ ability to customize dosing regimens,” medical experts opined in another published paper further adding that, “unless prescribed with caution, combination drugs may result in over treatment for patients who may be controlled with a single drug or fewer doses of combined medications if dosed concomitantly.” Therefore a viable option of reducing pill burden of patients is by deprescribing of medicines as and when needed. Other possible methods include lifestyle modification, dietary restrictions, physiotherapy and exercise. All these measures form a part of what is popularly known as Naturopathy i.e., treatment of illness by using diet, herbs, exercises etc without using standard drugs or surgery though naturopathy might not be a feasible option in all cases of severe as well as several cases of moderate disease conditions. However, in case of a majority of mild disease states like mild hypertension, indigestion etc naturopathy could possibly prove to be a good alternative for treating these conditions without any intrusive or invasive medical interventions if undertaken under exert guidance and supervision, avoiding making visits to fake as well as faith healers and roadside quacks. Even in case of moderate and severe disease conditions deprescribing needs to be seriously considered on regular basis by the prescribers wherever needed for the overall benefit of the patients. 

(Author teaches at the Dept. of Pharmaceutical Sciences, University of Kashmir)

World Pharmacists’ Day 2020: Role of pharmacy professionals in transforming global health

World Pharmacist Day is celebrated every year on September 25^th worldwide under the aegis of International Pharmaceutical Federation (FIP) which is an international body representing over four million pharmacists, educators and pharmaceutical scientists. FIP is a non-governmental organization that was established on this day in 1912 and has been collaborating with the World Health Organization since 1948. This year’s theme for the day has been chosen to be “Transforming global health”. While describing the main aim behind these celebrations, President of FIP, Dominique Jordan has stated that “We aim to show how pharmacists contribute to a world where everyone benefits from access to safe, effective, quality and affordable medicines and health technologies, as well as from pharmaceutical care services”. The purpose of World Pharmacists Day, which was brought to life at the FIP Council 2009 in Istanbul, was to encourage activities that promote and advocate the role of the pharmacist in improving health in every corner of the world. Main objective of the World Pharmacist Day campaign is to raise awareness about the professional activities of a qualified pharmacist and to educate the public on their significant role and crucial responsibilities in healthcare system and also to inculcate a sense of pride, solidarity and awareness among the pharmacy professionals on a global level. Pharmacists represent the third largest healthcare professional group in the world and India too is home to more than ten lakh registered pharmacists. After bringing out Pharmaceutical Workforce Development Goals in 2016, FIP has unveiled its “FIP Development Goals” this year on September 21 outlining measures needed to develop this profession in consonance with Sustainable Development Goals of the United Nations. 

International Pharmaceutical Federation (FIP) has selected the theme of “transforming global health” primarily with a view to lay a roadmap on how to make progress on its twenty one FIP Development Goals in the coming years so that substantial headway could be made in improving global health in sync with UN Sustainable Development Goals. Though this might seem to be an attainable goal in the global context owing to their considerable progress already made in their respective healthcare sectors, it is being perceived by many as a far-fetched dream back home in the national backdrop. Looking at the situation vis-à-vis pharmacy workforce, education and science within India it appears that the country is lagging far behind than developed nations whose FIP members have coined this theme for this year’s world pharmacist day in light of their own regional contexts. In a country where almost 65% population is believed to lack access to medicines as per World Medicines Situation report of WHO, standards of healthcare continue to be quite low that was duly accepted by the government at the onset of this year’s pandemic, quality and effectiveness of medicines is doubtful and their safety is not monitored systematically in all the healthcare facilities. Further prescribing and dispensing practices are flawed and drug use patterns among patients are not up to the mark. Pharmacy workforce though qualified is not empowered and integrated with the healthcare team mainly comprising of doctors and nurses. Clinical pharmacy departments and services within government hospitals are almost non-existent and other good practices with respect to drug selection, procurement, tendering, quantification, storage, distribution and use are rarely followed. As such primary responsibility and challenge before the pharmacists within India continues to be the service delivery to the utmost satisfaction of the system as well as the patients. Continuation and upgradation of their services amid severe financial, logistic and systemic constraints are their immediate concerns before they could think about transformation of the national health scenario let alone global health. Nevertheless pharmacists can contribute in their own modest and feasible way in improving the healthcare system and maximizing the therapeutic, clinical, economic and humanistic outcomes of patients through their concerted education, scientific research and practice-based initiatives. A sizeable number of qualified pharmacists have already been contributing substantially in these spheres all across the country in spite of all their limitations and there is no doubt that well-qualified and professionally trained pharmacists can contribute significantly towards improving as well as transforming national health that in turn will automatically contribute to the global health owing to the fact that India is home to more than 138 crore human beings. 

Need of the hour is to re-orient our pharmacy education and profession in India towards hospital and clinical pharmacy, enhance competencies, clinical skills, motivation and efficiency levels of pharmacy graduates and work towards their capacity building for making them an integral part of the health care system where they can assist the medical practitioners in providing optimal evidence-based care to the patients. Our pharmacists should be well-equipped, professionally trained and legally empowered to participate in medical ward rounds and give assistance to doctors in selection of an ideal drug therapies and their dosage. They should master the art and skill of drug therapy and disease-state monitoring for rational therapeutics as well as rational diagnostics. Our pharmacists need to be professionally fit to render adverse drug reaction and therapeutic drug monitoring services, detection of medication errors and other drug-related problems, patient counseling, drug and poison information services, pharmaco-economic and pharmaceutical care services, detection of drug interactions besides other hospital and community pharmacy services. Additionally they should be in a position to contribute towards formulation of hospital formularies, drugs and therapeutics committees, standard treatment guidelines and medicines management in hospitals. Pharmacists must be capable of evaluating the effectiveness and rationality of medication therapy, in improving patient safety, in stimulating improvements and standardization in medication-use processes, in minimizing costs of medication therapy and in meeting or exceeding internal and external quality standards. They should also be competent to suggest policy measures and interventions for the improved use of medicines both within and outside the hospitals. 

Once our pharmacists become well-equipped, professionally trained and technically competent to render all these kinds of services there ought to be adequate administrative structures and legal statutory framework in place to empower them to deliver those services. Pharmacy Practice Regulations of 2015 that have already been notified by the Pharmacy Council of India in concurrence with the Govt. of India on January 15^th, 2016. These regulations need to be adopted by all the state and UT governments and implemented in all district and divisional level secondary and tertiary care hospitals. Every such hospital should have a full-fledged clinical pharmacy department with adequate workforce, infrastructure, budget and statutory powers for making necessary interventions as and when required. Roles and responsibilities of clinical pharmacists within the hospital settings should be very well defined and there should be necessary supervision and monitoring to ensure compliance with the duties assigned to them. Coronavirus pandemic has exposed the chinks in some of the best healthcare systems of the world besides leaving healthcare systems of developing nations grappling with their inadequate workforce, infrastructure and other facilities in the face of an unprecedented outbreak of the disease. Simultaneously it has underscored the need to revisit, review and revive healthcare policies, settings, facilities and the procedures with a view to carve adequate space for the professionally qualified and well-trained people like pharmacists to contribute towards confronting such challenges and unforeseen circumstances. During this pandemic we have seen even nursing orderlies and multi-purpose health workers being employed to combat the consequences of the outbreak at the spur of the moment whereas there should have been proper disaster management rules in places to allow only qualified and well-trained personnel to step in at such occasions. Now the whole world must strive to develop human resource for any such eventuality in future and pharmacists are a force to reckon with in this direction.