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In Conversation: Tila Khan, MVSc, PhD, DBT/Wellcome Trust India Alliance Early Career Fellow, School of Medical Science & Technology, Indian Institute of Technology Kharagpur

May 10, 2022

Tila comes from a Veterinary background with PhD in virology and vaccine development from Virginia Tech, USA. During her post-doctoral research at the Indian Institute of Technology Kharagpur, she was awarded an international research grant entitled “Robert Austrian Research Grant” funded by the 10th International Symposium on Pneumococci and Pneumococcal Disease Board-2016, to pursue research in pneumococcal vaccinology and associations between respiratory viruses and bacteria in HIV-affected families.

I come with basic training in veterinary sciences and PhD in viral vaccine development from Virginia Tech, USA. For my entire six year career post PhD at the Indian Institute of Technology Kharagpur, we are interested in building the evidence base for vaccine access to high risk groups such as children living with HIV, pregnant women and infants of rural West Bengal. This includes studies on access of pneumococcal conjugate vaccines and Hemophilus influenzae type B vaccines to children living with HIV. With the “Robert Austrian Research Grant” in pneumococcal vaccinology, we looked into the impact of pneumococcal vaccines on the nasopharyngeal carriage of respiratory viruses and bacteria in HIV-affected families.

With this work, I became highly interested in public health and rural healthcare. We found that respiratory infections are highly prevalent, many of which are vaccine preventable. However, until the COVID-19 pandemic there was no system in place in the primary and secondary health centers of this region for laboratory testing of respiratory viruses and bacteria. With this pandemic, we have seen how the evidence of risk of disease in pregnant women has led to the rollout of COVID-19 vaccines to pregnant women. The pandemic has also changed the mindset in India that vaccines are required across the life course including adults and elderly. Lack of laboratory documentation of disease leads to underestimation of their burden and lack of awareness among clinicians and policy makers about the need for vaccines. In the DBT/Wellcome Trust India Alliance Grant-2020, we are working on building the evidence base for maternal immunization by setting up surveillance systems for influenza, respiratory syncytial virus (RSV) and SARS-CoV-2 in different health centers of a rural district of West Bengal, for estimating the burden of respiratory pathogens in children; understanding the impact of influenza, RSV and SARS-CoV-2 in pregnant women and infants and, build the awareness about maternal immunization. We are also conducting interviews with pregnant women in District to seek out information on attitudes towards immunization and underlying knowledge of vaccine preventable respiratory infections. Together these works would build the evidence base for maternal vaccines in India.

In the Lancet Commission, I am primarily working on evidence synthesis for identifying and laying a map of suitable and effective “technologies” for strengthening immunization program in India and for equitable vaccine access to vulnerable groups and hard to reach populations. With this work, we are looking into all the technologies available worldwide, and of these, which strategies India could introduce and how the existing programs and schemes be strengthened. I am also interested in the Human Resource works which relates to my own work on the engagement of citizens for understanding their needs, expectations and the grass root reality so that high quality health care reaches all.
Quality health care is a fundamental right of every citizen. I think the main challenge in achieving UHC in India is the continued investment and interest of government in improvising health system, translation of programs into implementation, continued monitoring and delivery of schemes across villages. For this structural change is needed across the health system with improvements in health infrastructure at primary level, digitalization of health records, integration of programs, telemedicine and increasing the number of healthwork force in India. Further, to achieve quality of grass-root health services in the deprived sections of population, the community healthworkers such as ASHA workers need to be brought on fixed salaries, as these are the women who can bring change as seen with the success stories of polio and COVID-19 vaccines and maternal and child health care program.
Honestly, I am very hopeful with the impact of Commission’s efforts on Indian health system. It is so inspiring to see the motivation of so many visionaries, scientists, researchers, clinicians, sociologists, public health researchers, experts from finance, management and private sectors working together with the one mission of realizing UHC in India. I am confident with the combined research efforts the Commission would build a road map for achieving UHC.