“I also realised the power of research evidence being able to influence public health policy and practice” Soumya Swaminathan

What are your plans for WHO?

These are extraordinary plans. But what led you to the medical profession in the first place?

Why the particular interest in tuberculosis?

You eventually became director of NIRT. How did holding that position make a difference in the diagnosis and treatment of TB in India?

What are your memories of growing up with your famous father?

It sounds like you had a happy childhood and are now leading an exceptional life. What do you do outside of work?

Were there times when working as a woman scientist proved challenging?

[NEW DELHI] Growing up with a renowned geneticist for a father and a creative and socially responsible mother, Soumya Swaminathan practically had a set career path as a child. Today, she’s paved her own trail as WHO’s first chief scientist determined to revamp India’s TB programmes and lead the prioritisation of the use of digital technology to improve health care.Until recently, she was deputy director general of Programmes of the UN body. She has also served as secretary to the Indian government for health research and as director-general of the Indian Council of Medical Research (ICMR) . Apart from these, she is also known for her research on tuberculosis at the National Institute for Research in Tuberculosis (NIRT) , Chennai, which she joined in 1992 and went on to head.Swaminathan and her colleagues were among the first to scale up the use of molecular diagnostics for TB surveillance and to undertake large field trials of community-randomised strategies to deliver TB treatment to underserved populations.As the daughter of M.S. Swaminathan , a geneticist regarded as the father of India’s Green Revolution for his role in developing high-yielding varieties of rice and wheat, she is no stranger to high scientific research. In fact, it was childhood trips to her father’s lab and experimental wheat fields that further ignited Swaminathan’s passion in medical research.Now based in Geneva, Swaminathan loves being outdoors, traveling to all parts of the world, and soaking in different cultures and cuisines. She recently spoke with SciDev.Net’s Papiya Bhattacharya on her current role at WHO —a position that was created in March 2019 for her specifically—as well as her work in relation to global development.I hope to…further the use of science, technology and innovation in improving health care delivery. Now that people in the remotest areas of the world have mobile phones, we can leapfrog into an era of rapid information flow with virtual contact between patients and doctors. Artificial intelligence-based health applications are increasing rapidly and there is a need for a framework for regulation, validation and prequalification -- similar to the regulation of drugs, medical devices and vaccines. WHO has a unique role in advising countries on maximising the opportunities of digital technology and in ensuring their appropriate use.Our science division can play a catalytic role in promoting research, development and innovation in areas where traditional approaches have not worked. An example is the priority pathogens list developed by WHO after the 2014 Ebola outbreak and subsequent development of target product profiles. This action significantly increased the global activity in this area, resulting in the creation of the coalition for epidemic preparedness and subsequent work progressing on several vaccines for Lassa fever, Nipah and MERS viruses.We would also like to work with research funders, ministries of health and research institutions in developing countries to foster a model of research where national priorities drive global funding flows and not vice versa. This will ensure that global public goods in research are driven by country needs and deliver tangible impact at the country level.My love for animals led me to want to be a veterinarian. I was also very interested in genetics and research and had enrolled for a bachelor’s degree in zoology at Delhi University. But all my classmates were preparing for the medical entrance exam so I sat for it, too, and entered medical school quite by chance. I would have been equally happy pursuing a career in pure science.Once in medical school, I was drawn to children and wanted to be able to work with those who did not have a voice. [I wanted to work] where clinical skills were important in making a correct diagnosis. I enjoyed clinical medicine but found research exciting and challenging.My love for (and understanding of) clinical research grew at the Children's Hospital Los Angeles, where I took a post-doctoral fellowship in paediatric pulmonology, after which I never looked back. I studied breathing regulation in children, an area that was not well understood. In those two years, I got my teeth into research and gained invaluable experience that helped shape my subsequent career.I learnt how to devise a good research question and correlate it with clinical observations. I learnt to do hands-on experiments in the laboratory, construct my own equipment, to record and analyse data and to write a quality scientific paper. It was difficult to convince my peers that I could have a career in research in India (and indeed it was quite tough at the beginning), but I was determined to return.Both my husband and I were very clear that, unlike other Indian doctors who trained abroad, we would return. After four years training abroad, including a year at the Leicester Royal Infirmary , UK, I returned to India in 1991. In 1992, I found my niche at the Tuberculosis Research centre (now the National Institute for Research in Tuberculosis or NIRT) in Chennai.When I returned to India, I found that tuberculosis was still a huge problem both in adults and children and that it accounted for a lot of respiratory ill health and mortality. At NIRT, I was able to undertake multidisciplinary research, combining clinical and epidemiologic data with immunological, bacteriological and pharmacokinetic parameters -- something not possible in many medical colleges at that time.I also realised the power of research evidence being able to influence public health policy and practice. This spurred me to address questions that were relevant for India's TB and HIV programmes in the 1990s and 2000s.My team and I started a TB free Chennai project in 2012 when I assumed directorship of NIRT. The idea was to test, interpret results, and start treatment for TB all in the same day. It took a long time to take off—we had to negotiate with the government, Chennai corporation, administrators, voluntary organizations—but it is showing results now.The randomized clinical trials that my team conducted added to the knowledge base and helped shift treatment and prevention strategies for tuberculosis in HIV-infected people in India and globally. Our other major contributions were the extensive pharmacokinetic studies in adults and children, showing the inadequacy of dosing of some anti-TB drugs, as well as documentation of drug resistance rates in adults and children with TB and demonstrating the utility of molecular diagnostics in young children.I remember our house being full of students all the time, discussing their research work with my father in the evenings. They would take [my sisters and I] to the lab [and] the experimental wheat fields and let us accompany them on field trips. Maybe that is how I acquired my love of research.My father spent long hours away on work, but always found time for us, [his] three daughters. We especially looked forward to his return from trips as we knew he would have presents for all of us. On family trips, what I remember clearly is my father going into the kitchen of the hotel or guest house to thank the cooks and other attenders who had served us during our stay. He never forgot to thank the driver or the doorman and remembered their names with ease. He is very kind.When I was seven, he took my sisters and I on a trip without our mother because she had broken her leg. My sisters and I had long hair, and our father actually combed and plaited our hair—it was more like he parted our hair and kind of rolled it. I remember people laughing when they saw [how our hair was fixed.]Our mother was also a major influence on us and instilled in us a sense of social responsibility and sensitivity to those who were less fortunate. We accompanied her to construction sites where she helped set up crèches for the children of the construction site workers (now a large movement called Mobile Crèches ) and to rehearsals for large drama productions she directed with the students and staff of the institute. She taught us to be inquisitive, creative and bold – and to stand up for our beliefs.I love nature and take every opportunity to be outdoors. My favourite way of spending spare time or over the weekends is to go on long walks in the mountains or near a lake. This is of course easy to do in Geneva, but not so practical in Indian cities. I also love traveling and meeting people and soaking in different cultures, ways of life and cuisines. I have enjoyed travelling to remote sites in Asia and Africa, far away from the madding, touristy crowds.I do not think I faced any special challenges by being a woman. We were never brought up to think that we may either face obstacles or have an easier career path based on gender . Therefore, I just focused on my work and got on with my plans. There were situations where in a room full of men, I sometimes felt I was not being taken seriously, especially when I was younger. My (male) bosses were always very supportive, however, and gave me the confidence to learn how to manage situations and hold my own.I am happy that my journey has encouraged at least a few young women of the next generation in India and elsewhere to choose public health and research as fulfilling career paths.This piece was produced by SciDev.Net’s Asia & Pacific desk.