Sunday, August 15, 2010

India-centric Lancet ‘superbug’ story: a murky ‘courier express’ collaboration?

Amid huge media frenzy over the LANCET Infectious Diseases article that appeared on August 11, 2010, there are reasons why India should try retracting the story 'Emergence of a new antibiotic resistance mechanism in India…' (sorry, it's a closed access article despite that it was funded by EU and Wellcome Trust, and you will have to shed ample money to read it in full!). On a quick, editorial read out, it appears that the authors have possibly flouted several pre-publishing requirements:

  1. None of the Indian and other South Asian authors is very well known researcher or clinician (by their publication record); why were they invited for this study and their trips paid out by Pharma players; just for hunting isolates?
  2. Why convenient sampling at tertiary hospitals?
  3. Who cleared transfer of isolates from India to UK? Do Indian hospitals mentioned in the study hold export licenses for classified biological agents? Do they have HMSC [an Indian Council of Medical Research (ICMR) watch-dog] clearances?
  4. Were the culture and antibiotic sensitivity screening protocols approved by biosafety committees at respective Indian centers and hospitals?
  5. Why Hinduja Hospital Team dropped for authorships when there were analyses of isolates presented from Mumbai? How many isolates did Hinduja ship to UK and how?
  6. How the isolates got shipped to UK? Did the first author Kumarasamy carried them over to UK and his trip funded by Wyeth as mentioned?
  7. If my doubts above are genuine, then, should they be overlooked, especially, when the study falls within the ambit of prestigious funding agencies such as EU and Wellcome Trust?

There are additional problems:

(a) No mention of how many isolates supplied by whom? (b) much of the discussion directed towards denting medical tourism in India and the premise based on popular media reports and articles from 'God-forsaken' journals (J Assoc Physician India and J Infect Dev Ctries ) (c) it seems that the involvement of Indian centers was merely for collecting the isolates and such a research collaboration can not be justified. Authorships should not be given just for the isolation of cultures and provision of demographic and patient data.

The above points must be investigated and taken up (by the ICMR and the Indian Health Ministry) with the journal and the Indian institutions/hospitals that cleared implementation of the study. Unless documents supporting ethical and biosafety clearances produced, the journal should be asked to retract the report with apology. Moreover, the ICMR and the Indian agencies should formulate concrete policies on such ad-hoc collaborations which are meant only for hunting and exporting the genetic material and patient isolates.