{"id":58115,"date":"2024-04-23T09:51:02","date_gmt":"2024-04-23T13:51:02","guid":{"rendered":"https:\/\/mittalsouthasiainstitute.harvard.edu\/?p=58115"},"modified":"2024-09-30T12:04:02","modified_gmt":"2024-09-30T16:04:02","slug":"genetics-medicine","status":"publish","type":"post","link":"https:\/\/mittalsouthasiainstitute.harvard.edu\/2024\/04\/genetics-medicine\/","title":{"rendered":"Annual Symposium Preview: Genetics and Medicine"},"content":{"rendered":"

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Vijay Chandru<\/strong>, one of the speakers in the \u201cGenetics and Medicine\u201d panel at LMSAI\u2019s Annual Cambridge Symposium: Science and Technology<\/a>, is a Visiting Scientist in the Department of Global Health and Population at the Harvard  T.H Chan School of Public Health. He is an academic entrepreneur, having founded several digital health companies including Strand Life Sciences<\/a>, a life science informatics and precision medicine solutions  company based in Bangalore, India, after spending 23 years in academia. He was recognized as a \u201cTechnology Pioneer\u201d by the World Economic Forum and was recently elected a Fellow<\/a> of the American Association for the Advancement of Science (AAAS) in Washington DC. He shared more about his life\u2019s work in the Q&A below.<\/p>\n

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Mittal Institute:<\/strong><\/span> Vijay, thank you for speaking with us ahead of our Annual Cambridge Symposium! You began your career as an academic, having taught data and decision science for over two decades at Purdue University, Indiana, and the Indian Institute of Science. Can you tell our community what \u201cdata and decision science\u201d means to you, and why you initially decided to enter academia?<\/strong><\/p>\n

Vijay Chandru:<\/strong>I trained in electrical engineering in India and at UCLA, and at MIT, I chose to focus on systems science and operations research which were the mathematical and computational methods for modeling and decision support in a variety of applied domains. This included logistics and manufacturing, energy management, and engineering design of semiconductors and communication networks. Electrical engineers, like physicists, are natural intellectual poachers and I enjoyed using the tools I had at my disposal to enter new domains and have some impact.<\/p>\n

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Dr. Vijay Chandru.<\/i><\/span><\/p>\n

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The choice of an academic career happened as I really enjoyed teaching, and I felt that staying in academia would allow me to hone my analytical skills. At Purdue University, as an assistant professor, I studied, taught, and carried out research in computational geometry and computational logic towards automated theorem proving, which was then considered the foundation for machine intelligence.<\/p>\n

After my tenure at Purdue, I moved to India \u2013 first on a sabbatical \u2013 and found colleagues at the Indian Institute of Science and at the Centre for AI and Robotics in Bangalore with whom I worked on machine learning in the 1990s well before artificial intelligence and machine learning became fashionable. Around 1996, together with three colleagues, I convened the Perceptual Computing Lab (\u201cpercolat\u201d). We built a reputation of audacious (extreme) engineering, which began by exploring translational problems that could be addressed by algorithmic problem-solving. A senior mentor at the Institute, Professor Roddam Narasimha, anointed us the keepers of the classical Indian tradition of computational positivism (drik + ganita = Siddhanta), which says that all knowledge follows from observation and calculation. It was a splendid time and resulted in the handheld \u201cSimputer\u201d that made a huge splash as a device of radical simplicity for universal access bridging the digital divide. These \u201cpercolat\u201d years also prepared us for a launch into entrepreneurship.<\/p>\n

Mittal Institute:<\/span> You have founded numerous companies focused on biotech and digital health. Can you share more about one of them, Strand Life Sciences<\/a>, India\u2019s leading precision medicine company, which you co-founded in 2000 and led as executive chairman until 2018? What gave you the idea, and how does the company make a difference in the digital health space?<\/strong><\/p>\n

Vijay Chandru: <\/strong>Biology was entering its 4th paradigm as a data-driven science in the late ’90s. The human genome project was on and instrumentation and measurement in molecular biology was rapidly improving. Experimental data was exploding and biologists simply didn\u2019t have the right data analytics to handle this. This was a great opportunity for folks like me to jump in and make a difference. I tried initially to work at the interdisciplinary interface within academia at the Indian Institute of Science where we had outstanding biologists. But it was hard to break out of silos, so a group of us decided to offer consulting services to biologists in the industry.<\/p>\n

Eventually, this led to a company called Strand Genomics (later renamed Strand Life Sciences) where we built a robust data science platform for biologists leveraging high dimensional data visualization and classical machine learning. We called it AVADIS for Access, Visualize, Analyze to Discover \u2013 the basic workflow in computational biology. AVADIS included a very early LLM called Grammatica\u00ae that Strand created using natural language processing to read all of Pubmed in 2004. Deep learning was not a thing yet so we relied on old fashioned rule based grammar implementation and a combination of ontologies to represent the extracted knowledge.\u00a0<\/p>\n

We pivoted into building our own labs and becoming a genomics company in 2012 for the Indian market. Strand is fairly unique in that since around 2014, we have had a fully integrated capability of going from a sample to a clinical report using an internally built informatics stack \u2013 handling the nitty-gritty of aligning sequencing data, calling out variants, and interpreting the clinical findings. We were the first lab in South Asia to be accredited by CAP-ISO for next-generation sequencing diagnostics. Cancer patients could now have their tumor signal analyzed for pharmacogenomic treatment choices, children with rare genetic diseases were diagnosed, and Strand helped India enter the age of precision medicine. Accelerated by the need for genomic surveillance during the pandemic, India now has an enormous capacity in genomics that is world-class. It has been really satisfying to have played a role in this transformation.<\/p>\n

Accelerated by the need for genomic surveillance during the pandemic, India now has enormous capacity in genomics that is world class. It has been really satisfying to have played a role in this transformation.<\/span><\/h1>\n

Mittal Institute:<\/strong><\/span> How has the field of genomics changed since 2000? What are some exciting advances?<\/strong><\/p>\n

Vijay Chandru:\u00a0<\/strong>The human genome project, a moonshot costing around three billion dollars over 15 years of multi-institutional, international participation, led to the first reference human genome that was published in 2003. But sequencing the next genomes was still quite laborious and extremely expensive \u2013 in computer science terms, it was a gigantic stochastic, dynamic programming problem.<\/p>\n

Realizing that sequencing could be achieved with massive parallelization of short reads resulted in next-generation sequencing (NGS) becoming available in 2004-2007. The timing was perfect with advances in computing hardware for parallelism also arriving in the firmament. These sequencers began to make a difference in clinical diagnostic applications by around 2010 since enough of the human genome had been annotated. By 2012, the use of NGS was widespread and our company Strand established the first clinical-grade laboratory in South Asia by 2013 in Bangalore.<\/p>\n

The promise of a \u201cMoore\u2019s Law\u201d equivalent for genomics was the reason to get on this bandwagon early. Thought leaders like Professor Charles Cantor predicted that a $100 whole genome would be a tipping point. We are close to that tipping point today at about $250-300. Nowadays, the synthesis of AI and biology \u2013 the so-called TechBio push is evident. \u201cWe need to be ready for biotech\u2019s ChatGPT moment,\u201d says the silicon-valley oracle, Eric Schmidt, in a recent article in TIME magazine. There may be a possibility of a US-India partnership in implementing Schmidt\u2019s agenda on generative AI and biotechnology, which I look forward to<\/span>.<\/p>\n

Mittal Institute:<\/span> What are some challenges the field still faces, either geographically in South Asia or in general?<\/strong><\/p>\n

Vijay Chandru: <\/strong>The challenges in leveraging innovative technologies like genomics in the context of Low- and Middle-income Countries, including South Asia, are numerous. With a lack of an endowed \u201cpayer\u201d system, most of these cutting-edge technologies only get directed to the so-called creamy layer of society that can pay \u201cout of pocket.\u201d Innovation just doesn\u2019t have that market pull that is needed. As my dear friend Kiran Mazumdar often says, we must use \u201caffordability\u201d as a key driver of innovation in India. Today, Strand offers a whole exome plus sequencing at high depth along with genetic counseling at $145 a test as promised by the Chairperson of Reliance, our major shareholder. It is already the world\u2019s most affordable solution by far, but we need to get it down by a factor of three to ten times lower before the Cantor tipping point ($100 for a whole genome sequencing) takes effect and the major misalignment of health systems can be corrected.<\/p>\n

This misalignment that our health systems is characterized by the neglect of preventive care and early detection of sickness that would result in more affordable acute care. The biggest challenge in South Asia will be to reorient the focus on primary health care coverage while continuing to build capacity for secondary and tertiary care. This re-alignment or re-imagination can be led by technology innovation, following the example of how India stack has enabled financial inclusion. The CoWIN portal created as a digital public infrastructure for vaccination tracking and smart logistics during the latter part of the pandemic holds promise for a rollout of digital health at the population scale. <\/span><\/strong><\/p>\n

Mittal Institute:<\/span> What are some things you hope the audience takes away from your Genetics and Medicine panel at our upcoming symposium?<\/strong><\/p>\n

Vijay Chandru: <\/strong>With co-panelists Prof. David Reich, one of the world\u2019s leading experts on population genetics, and Prof. Priya Moorjani,\u00a0a young outstanding bioinformatics scholar, the audience will get an extraordinary introduction to the richness of the genetics of India. Currently, because of the prevailing historical practices of endogamy and consanguinity, India manifests a lot of genetic-related disorders and health challenges. I will focus on these to complement David and Priya\u2019s findings. I will also briefly mention the public health policy developments for these rare and orphan diseases in India and will touch on the emergent capacity for genomics and genomic medicine that India is putting in place.<\/p>\n

Mittal Institute:<\/span> What research are you focusing on during your time as a Visiting Scientist here at Harvard? And what is next for you, post appointment?<\/strong><\/p>\n

Vijay Chandru:\u00a0<\/strong>Through the guest lecture at HSPH, I have initiated a focus in my work towards building a master plan for addressing health care for rare and orphan diseases patients in India. At Mittal Institute, the work towards the Lancet Citizen\u2019s Commission for reimagining India\u2019s health systems, where I am co-chairing the technology workstream, has been a focus since last August. I have also interacted with scholars at the Mittal Institute working on the Climateverse project on health-related surveillance and epidemiology. Post-appointment, nothing much will change as I will continue to work on these topics in India through ARTPark and cross-border research collaborations.<\/p>\n

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\u2606 The views represented herein are those of the interview subjects and do not necessarily reflect the views of LMSAI, its staff, or its steering committee.<\/em><\/p>\n

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Vijay Chandru, one of the speakers in the \u201cGenetics and Medicine\u201d panel at LMSAI\u2019s Annual Cambridge Symposium: Science and Technology, is a Visiting Scientist in the Department of Global Health and Population at the Harvard\u00a0 T.H Chan School of Public Health. He is an academic entrepreneur, having founded a number of digital health companies including Strand Life Sciences, a life science informatics and precision medicine solutions \u00a0company based in Bangalore, India, after spending 23 years in academia. He was recognized as a \u201cTechnology Pioneer\u201d by the World Economic Forum\u00a0and was recently elected a Fellow of the American Association for the Advancement of Science (AAAS) in Washington DC. 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