Gagandeep Kang has often been described as the country’s “vaccine godmother”. Lauded for her work in building national rotavirus and typhoid surveillance networks, the 56-year-old scientist currently heads the Translational Health Science and Technology Institute, Faridabad.

On April 16, she became the first woman from India to become a Fellow of the Royal Society of London, a 356-year-old institution that has awarded 51 eminent scientists along with 10 new Foreign Members and one Honorary Fellow for their exceptional contributions to science.

In an interview with BL ink , she discusses what the award means, tips on striking a work-life balance, coping with sexism, and her idea of setting up Controlled Human Infection Models to speed up drug testing. Edited excerpts:

How hard was it for you to get here, now that you’re placed in the same ranks as Newton and Darwin, also Royal Society Fellows?

One, I don’t think I’m on the same platform as Newton and Darwin or anybody else. This is recognition that you’ve done good work. It doesn’t mean necessarily that you are among the best of the best. About being the first Indian woman, well women have only been admitted as Fellows of the Royal society over the last 60-70 years. And microbiologist Lalita Ramakrishnan, of Indian origin, was awarded the FRS in 2018. The only thing is she doesn’t live and work in India.

For me the big thing is that the importance of medical research is being recognised. Fundamental discoveries in mathematics, physics and chemistry are often treated as real science, benefiting many more people on a longer timeline. Medical research tends to be much more immediate. In that sense, recognising the quality of what we do on an international platform is tremendously valued. Medical research is also all about teams. For me, the big win was that we were able to build that kind of a team in India.

Is this recognition for your work on the rotavirus vaccine or a body of work?

It is for a body of work. I’d like to tell people that I work on things apart from rotavirus (laughs). I work on gut infections. More specifically, gut infections in a child, in their family, in their environment.

Tell us a bit about your growing-up years.

My father was in the Railways, my mother a teacher. We moved around a lot, mostly across north and east India. I changed schools 10 times. When I was 12, my father and I built our own lab at home. We’d buy test tubes and chemicals from Kolkata. Once I made hydrogen, nearly blasting our roof. Exploring the natural environment, having a microscope, cutting up leaves and observing them was what I did for fun.

During summers we used to visit our grandparents and everybody there read. My uncle collected illustrated classics, giving us our summer’s delight. The back pages carried career advice. I once saw an ad calling for air hostesses, who would get to travel the world. Having never been on a plane before, I was like, ‘Oh boy! This is what I want to do!’ But that didn’t happen (laughs).

Any career advice for women scientists? Many have spoken about how difficult it was for them to return to their profession after a break.

I never took a break. I had an eight-week maternity leave for both my children while I was doing my PhD. There was a time when I was pregnant and my husband was in hospital. We had a friend staying at home with her daughter, whose husband was also in hospital and much sicker. I called my mother. She came and took away my older son and said, “Call me when you’re ready to have him back”. With that kind of support system you can manage. I have a friend who stayed up nights with me to type out my PhD on her computer.

My career advice for women is to have really good friends. Science isn’t any different from other fields. Whatever you choose to do, you have to commit to it.

Why do we see such few women in top leadership roles in science?

You get to the top by sticking it out. I cannot conceive of myself without work. It is what drives your definition of who you want to be. The one thing valuable to have is flexibility. If I know what my goals are, give me the time and space to achieve them when I can, and not between 9 and 5. Create the opportunities for me — childcare on site, flexible working hours and so on — to fulfil all my varied responsibilities.

Is it a lot harder for women to earn trust in their capabilities?

I was in a really empowering place — the Christian Medical College in Vellore. But when it came to a reimbursement-based grant that a male colleague and I had been selected for, he was given the grant and I was asked to go find a guarantor who would lend me ₹25 lakh to show as safety deposit. I came crying out of that meeting... They did not ask this of the guy who had exactly the same grant and qualifications.

There are other daily discriminations. I would be talking in a meeting and a man would just start talking like I hadn’t started. Now I’ve gotten to a point where if I’m speaking nobody else will speak up. It’s taken a long time to get here.

Tell us about your human immunology research.

I’ve been studying human immunology using vaccines as a tool. We started with studies based on oral vaccines rotavirus and polio and we do a deep characterisation of the immune response. The other area is CHIMs (Controlled human infection models) which isn’t that different from clinical research. It’s about having a controlled infection that allows you to characterise disease and test whether an intervention works or not. What I’m talking about is an approach to research that shortens the path to getting to human testing rather than the current staged process involving pre-clinical studies, immunogenicity in humans and, finally, efficacy tests. The number of people involved is larger in each stage. It allows you to make decisions about failed products earlier and that way you put fewer people at risk of being involved in testing futile interventions.

But how will you negotiate India’s trust deficit and poor ethical record in medical trials?

Where will we find altruistic people who will volunteer for such a study? I don’t know. This is where we need the trust. In the west, people seek out hospitals that do clinical trials because they have learnt that these make better hospitals. In India, it is the other way around. The Institute of Medicine has done a nice report which is about building a learning health system. The idea is that everybody is a participant in the next drug or treatment. How do we build a system that is like that? Society should know that to bring new intervention to the market chances are their hospital data will be used to bring new treatments.

Given you have also worked extensively on rotavirus, what can we do to bring down prevalence rates further?

In India, 40 per cent of all gastrointestinal hospital admission in children below five is due to rotavirus. The US saw a 90 per cent reduction of rotavirus related hospital admissions once the vaccines started to take effect. In India, the vaccine is in the program, but we do not expect it to be as effective as in the US. Based on efficacy trials, the vaccines prevent only 40 to 55 per cent of severe rotavirus cases because of the damaged gut environment. Basically, if your gut is inflamed and has seen bugs many times over a long period of time, it no longer reacts to bugs the way it would in a cleaner environment. That becomes a disadvantage for live oral vaccines. There is a lower immune response with each exposure because we’re seeing the virus too frequently. As solutions to this problem, we are looking at an injectable vaccine instead of an oral vaccine and I’ve also been working with a lot of interventions to improve immune responsiveness but everything I’ve tried, so far, has failed. I think, what might work is a neonatal dose of vaccine which means introducing the vaccine earlier, before children see too many infectious agents.

How can India lower its infant mortality rate?

Promoting safer births and good antenatal care will address a large component of the mortality rate. Other causes include vaccine preventable diseases and acute diseases. Antibiotics used appropriately and vaccines for diarrhoea and pneumonia have a role to play. The rest is access to healthcare. If you can get children to facilities there’s no reason why we can’t reduce the mortality even further.

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