• Manoj Swaminathan

Finding my ikigai ... 'Pharmacovigilance in Public Health'​

The 'lot many' months of COVID-19 lockdown, has allowed some people to answer these 'simple' questions: "What is it that gets you up every morning and keeps you going?" or "what is my personal legend?" and thankfully I am one of those fortunate ones who has found an answer to these simple questions!

I still recollect the screening round for 'Master of Public Health' application at one of the premier institutes in India (governed by the Department of Science and Technology, Govt of India). I had to submit a one-page write-up on 'Why I want to pursue MPH', and I ended up writing about the unmet need for Pharmacoepidemiology (in lay terms, studying the effect of medicines on well-defined population) in India. I must say that I was fortunate enough to be selected for the next round, which was a face-to-face interview with a panel of eight Public Health Stalwarts asking one question after the other.

There were only 15 Seats, but the competition seemed tight. There were over 100 aspirants, and in my case competitors, with most of them already working in the field of Public Health. I was amongst the youngest of all; a fresh MBBS pass out who had topped the Final year MBBS and aspiring to clear PG Entrance and pursue specialization (MD) in Pharmacology or Community Medicine. I had nothing to lose as my aspirations were reasonable and among the least sought after fields in the PG Entrance Examination. However, I saw a lot of hope in the eyes of my 62-year-old father, who had accompanied me to the capital city of Thiruvananthapuram (after a 36-hour train journey).

I maintained my stand in front of the interview panel that my only intention to pursue MPH is the unmet need for 'Pharmacoepidemiology' in India. I could also sense that most (if not all) of the panellists had heard this term for the first time, more so from an aspiring candidate. However, they would have heard about clinical Pharmacology, and they were already stalwarts in Epidemiology and Public Health.

Finally, at 8 PM, the results were announced, and all the 100+ aspirants headed towards the notice board to check if they had been selected. My dad was always considered to be 'lucky' in such cases and was the obvious choice for verifying the list in my case.

At the end of the first year of MPH, we had a month vacation, where we were expected to attend some workshops/ events. This time I was fortunate enough to be sponsored by WHO-SEARO to attend a 12-day long residential workshop on Promoting Rational Drug Use, at IIHMR Jaipur. On the last day of this workshop, we had to present a research topic that we would like to pursue after going back, and I randomly selected the analysis of drug reaction reports in the erstwhile National Pharmacovigilance Programme (NPVP). It was encouraging that Dr Kathleen Holloway and Dr.Vijay Thawani (facilitators of the workshop) liked the research idea.

This experience made it easy for the next step was the MPH dissertation, which was no doubt on the National Pharmacovigilance Programme (NPVP), with an Epidemiology expert like Dr.V Raman Kutty 'Sir' as my guide. Being from a premier institute made it easy to get approval to undertake a dissertation at the prestigious clinical pharmacology department of Seth GS Medical College and KEM Hospital, which was incidentally the South West Zonal Center for the NPVP.

Ever since the day when I submitted my dissertation, there has been no looking back, where I had (and will continue to have) the opportunity to work in the Pharmacovigilance domain, in both service providers as well as Pharma companies. Heading the global Pharmacovigilance function at 30 years of age in the largest Pharma company of India (and among the top 4 generic companies globally) was something I couldn't have even dreamt of.

I continue to remain passionate about Pharmacovigilance and have had the opportunity to participate as a speaker/panellist in several events nationally and Internationally, over these years. I am also fortunate to be in a country, which houses more than 50,000 personnel working in the field of Pharmacovigilance and catering to companies globally.

Adverse Drug Reactions (or side effects) are associated with more than 650,000 deaths every year, and gross under-reporting continues to remain a concern. Awareness continues to remain a challenge even among healthcare practitioners. Apart from PharmacoVigilance, fields like EcoPharmacoVigilance, MaterioVigilance, Vaccine Vigilance, HaemoVigilance, CosmetoVigilance, etc. continue to evolve, although very slowly in the developing world. There is an Unmet Need for Pharmacovigilance in Public Health, and probably the right time for giving back, or the time for VigiServe!