These played a significant and collaborative role in focusing attention on the use of biomedical research and practice in improving public health. The fruits of these efforts began to be felt across the country in the 1970s. This was the decade of translational nutrition. Results from biochemistry and intermediary metabolism were used to define what came to be known as protein-calorie malnutrition. The nutritive content and value of Indian food were catalogued for the first time. As the cause of goitre came to be known as the lack of iodine, a successful national campaign for the distribution and use of iodized salt was launched. And as the role of vitamin A in vision became known, the administration of mega doses of vitamin A to school-aged children was started, in order to counteract night blindness and associated aspects of vision impairment.

The enactment of the Indian Patents Act in 1970 that recognized processes instead of products allowed the growth of a large number of drug companies across India, both in the public and private sectors. As the cost of drugs plummeted, the effect on medical care and public health was perceptible. As India became party to the WTO patent regime since 2005, this special advantage we had of recognising only process patent has vanished. The government still has considerable freedom in 'unfreezing' many drugs and medical products from this restriction in the larger interest of national health. Despite this, many worry that the medical costs will skyrocket. Indian scientists are thus challenged to compete with the big pharma companies and invent new molecules, diagnostics and therapeutic products. How well they meet this challenge and come out winners is being keenly watched the world over. I remain hopeful that there will be several winners.

The reason for this optimism is because of some of the important and exciting developments that were initiated in the 1980s. This was the decade of new biology in India. Several research institutions devoted to modern biology came into being. Some university biology departments re-invented themselves through a 'make-over'. Many Indians trained abroad in the then-newly emerged disciplines of cell and molecular biology, genetic and recombinant techniques, immunology, structural biology and bioinformatics came back to work at these places. New medical institutions that included clinical and basic research as part of their charter emerged in the public, non-profit and corporate sectors. And the Department of Biotechnology (DBT) was born. It is from the programmes established by these scientists, the extra-mural grants and projects initiated by DBT and ICMR (and by DST, CSIR, ICAR, DRDO and DAE) that my optimism stems.

While the 1960s was the decade of the Green Revolution, the 1980s ushered in the White Revolution. What is striking about it is that it did not need 'high science'. What it needed was community participation, ownership and transparency in all its action. It was again during this decade that poultry and egg production went up in the country at an exponential level the Ovine Revolution on the steps of the Bovine. Of course, these are not related to translational biology per se. What they show is the power of community participation, empowerment and enterprise. They have surely made much of India healthier.

Now we turn to the 1990s. This was the decade of biotech companies. One of the first products that were marketed by them was the recombinant vaccine against Hepatitis B. Here was an example of translational biology not quite bench-to-bedside but bench-to-avoid-bedside. The academia-industry interaction that we were waiting for had arrived. The fact that indigenous production dropped the price by 100-fold meant vaccination became more prevalent and accessible to a far larger number of people. It is gratifying to note that today India makes and supplies about forty five percent of the world's need of vaccines against human diseases. State governments have taken pro-active measures and started 'biotech parks'. The number of academics and researchers turning into biotech entrepreneurs is steadily, though slowly, rising. The recent 'Golden Triangle' effort by the CSIR to bring academia, research laboratories and industry together is a welcome step in this enablement.

Stem cells are also found in some tissues and organs of the body. Since these occur in tissues that are already a product of differentiation and after the embryo has developed from the multicellular blob, these are referred to as adult stem cells or ASCs. They seem to have the ability to differentiate into several other cell types, though not as versatile as ESCs. ASCs are pluripotent. ASCs have been isolated from the bone marrow, muscles and one part of the eye. Claims have been made that they are present in the liver, kidney and a few other organs but it is not clear whether these are progenitor cells (develop only into the host tissue), transiently amplifying cells (to help repair host tissue damage) or actual stem cells. This debate will soon be resolved through research; and it is also expected that ASCs will be found in several other parts of the body.

The pluripotency of ASCs is attractive for their use in some therapeutic applications. The favouite source for such purposes is the bone marrow, which provides both hematopoietic stem cells and mesenchymal stem cells (MSCs), which can generate other cell types. Indeed, successful therapeutic use has so far been achieved using ASCs and in particular MSCs of bone marrow. In our own Bone marrow of a heart patient and inject them into the patient's heart area during surgery for a myocardial infarct, generate heart muscle cells and heal the patient. Based on encouraging results obtained in a trial using forty patients, a controlled multi-centre trial is currently on for the cardiomyocyte therapy of MI patients using autologous (same body source), bone marrow derived MSCs.
Successful use of bone marrow derived hematopoietic stem cells in treating severely anaemic patients has been going on for some time in India, well before the current excitement on stem cells. Here, the so-obtained hematopoietic cells are expanded in the laboratory to the desired numbers and administered to the patient. There has also been a report of the use of such autologous hematopoietic stem cells to treat rats suffering from retinal degeneration in their eyes. Administration of these cells intra-vitrially into the animal has been reported to have generated the desired blood vessel formation. No human experiments have yet been conducted in this connection.
When in 1998 it was reported that the limbus of the eye (the ring-like area surrounding the cornea, abutting the conjunctiva) harbours ASCs, an ophthalmologist harvested them, cultured them to generate the corneal epithelia and transplanted them on a few patients whose corneas were damaged due to chemical or fire burns. Significant restoration of vision was reported. Encouraged by this proof-of-principle, we at our institute initiated this therapy on needy patients in 2001 with success. To date, this limbal stem cell based therapy has restored eye sight in significant measure to over three hundred patients at our centre. Currently, this therapeutic measure is being followed in a few other ophthalmic centres in India.

When disease affects one person the doctor fights to win over it and cure the sick person. When disease affects a large number, the fight turns into a battle or even a war. Family doctors engage in fights while public health people engage in wars. The family doctor is concerned with incidence while the public health people are concerned with prevalence. Scale matters here and thus information becomes vital. The branch of science that provides such information is Epidemiology. It gives us data on how many are affected, where all in a given area is the illness prevalent, what appear to be the factors associated with the prevalent illness, and so on. It was information of this kind that helped India roll back childhood blindness, cataract of the eye lens, goitre, and more recently polio. Epidemiology also told us which geographical location in India is polio still prevalent in. Information of this kind is vital to fight a war and win it. Sadly, the field of epidemiology has become weak in India over the last decade or two, at a time when translational medicine is ascendant. We need to correct this weakness and fast.

Epidemiology is an informational science, one that helps us in the war against diseases prevalent. Information is a weapon; to be informed is to be armed. To be armed is to be enabled in the battle against the enemy. India has successfully fought and conquered smallpox. It is close to winning over leprosy, polio and goitre. In order that we win other prevalent and emerging diseases, we need translational medicine and public health. The record so far is encouraging and gives us hope and confidence for the future.