Remembering Paintal

For scientist A.S. Paintal, a champion of self-reliance, there was no science without ethical values. A tribute on the anniversary of his birth.

GIVEN the currently evident propensity of the Indian science administration to go public with claims of `breakthroughs' in medical research, it is not entirely surprising that the passing of the man who upheld scientific values and integrity more than his achievements in research should have been virtually ignored by the Indian scientocracy. Not that his research was lowly by any yardstick. He was one of the finest medical scientists and perhaps the greatest physiologist that India has produced.

Autar Singh Paintal passed away on December 21, 2004, at the age of 79. At a time when most top scientists of his age would have secured sinecure positions, and would be heading various committees or advisory bodies of the government, Paintal continued to do research at the Vallabhbhai Patel (V.P.) Chest Institute of Delhi University. The field of receptors associated with cardiovascular and pulmonary mechanisms, with which his name has been inextricably linked for decades, continued to engage him.

As the Director of V. P. Chest Institute for 25 years during 1964-90, he assiduously established and nurtured this research discipline. He also served as Director-General of the Indian Council of Medical Research (ICMR) during 1985-91 and was president of the Indian National Science Academy (INSA) during 1986-91. On the day he died there was the customary press release from the V.P. Chest Institute, but neither the INSA nor the ICMR, the country's major academic hubs, thought it fit to issue an obituary as a mark of respect. His birth anniversary, September 24, is a good occasion to recall his valuable contributions to Indian science.

Throughout his career, Paintal was seriously concerned about the declining standards in Indian science, both in terms of scientific ethics and quality of research. It was only natural for someone like him, whose path-breaking discoveries in physiology opened up new research areas, to feel so. Indeed, he was a nationalist in his approach to science. In an address at the Indian Institute of Technology (IIT), Delhi, in 1989 he had stated that he was, like most Indian scientists, first international in the approach to science but nationally inclined, but that he was trying to become one of the smaller group of nationalists who are also internationally inclined. He urged every Indian scientist to try and do the same. "It will not be easy," he said, "as it is full of risks for one's reputation and standing... . The distinction between the two groups is subtle. But it is important. It determines whether your loyalties and feelings are primarily to international science or towards Indian science and scientists." He wanted this perspective to be the basis even for evaluating scientists and research. "It will Indianise our scientific organisations. Some of them certainly need more Indianisation," he remarked.

He was highly critical of assessing the performance of everyone on the basis of the number of publications and their citations. "As a general rule," he said, "it is quite out of place... it undermines the far more useful work in more urgent fields (such as leprosy, of no value to the West). It is, therefore, only fair that such scientists are assessed on the basis of other criteria such as usefulness of their work to Indian S&T [Science and Technology] and social value. In fact, by a judicious mix of these criteria it should be possible to make a fair judgment about whether the best `tomato' is better than the best `potato'... even in the same institute. Such approaches ensure that certain people who have devoted a large part of their time to the development and housekeeping aspects of scientific institutions are not left out in the assessment process." However, his efforts to evolve such a system of assessment for all Indian institutions (as the ICMR Director-General and as INSA president) met only with lukewarm responses.

Paintal was equally concerned about the lack of technological innovation in the country. He himself had done most of his research by building his own instruments with the most efficient use of resources at his disposal. He had picked up knowledge of the necessary techniques of electronics from engineers at Edinburgh, where he did his doctoral work. He continued with this approach to the very last.

"Compared to the dynamic first half of the 20th Century, the intellectuals of the second half look like `lotus eaters', interested in, and promoting, a comfortable existence, secure jobs with attractive perquisites and ostentatious lifestyles with no aim or desire to achieve anything in particular," he said in his convocation address at IIT-Kanpur in 1985. "We seem to have totally given up any desire to develop Indian technology... We have given up self-reliance as a driving force. We are back to subservience of a different kind - technological subservience... There is no question of self-help... [O]ur technologists and intellectuals interested in easy quick remedies for the problems of India seem to be ensuring that this approach is made to look respectable... The self-respect that we had acquired in the first half of this century has been lost in the second half. We had acquired respect internationally through a combination of self-help and self-denial. All this respect had to obviously disappear once we started accepting aid," he said. Paintal would have been deeply pained to see the state of affairs in the country in the later years into the 21st Century.

In 1988, there was an interesting episode involving Paintal and the former United States ambassador to India, Gunther Dean. Incensed by an address given by Paintal at Calcutta University in which he had called upon students to exercise intellectual independence and not to depend on external aid for the development of their university, Dean apparently told Paintal at a tea party that his words would prove to be bad for him personally.

Paintal used to lament the fact that, as a nation, we were not organised to do good applied work. Using the health data of soldiers stationed at high altitudes of 3,000-5,000 metres in the years after the Chinese war, many of whom suffered from High-Altitude Pulmonary Oedema (HAPO), he was able to pinpoint the relevance of his own work on `juxta-pulmonary capillary' receptors (J-receptors) to HAPO, the associated symptoms of dry cough and muscle weakness and their linkages to coronary problems. But beyond carrying out work on high-altitude problems in his own laboratory, he could not get his proposal for an institute for mountain research or high-altitude studies implemented. He made this proposal in his presidential address at the Indian Science Congress in 1985. In fact, he was so concerned about the larger problems of the Himalayan region that he wanted the government to set up a department of mountain development for mountain preservation and sustainable development, which would take up mountain research among other activities. This advice has gone unheeded. It would be a fitting tribute to Paintal to set up such a civilian institute and name it after him.

If there was any Indian scientist who never hesitated to call a spade a spade, it was Paintal. Neither the stature of the scientist nor the institution deterred him from speaking out if the issue at hand fell short of the ethical values he stood for. As INSA president, for example, he wrote to a well-known scientist-administrator who had become Minister of Science and Technology to surrender the INSA's C.V. Raman Professorship Award arguing that in his position he would not be able to devote time to the research for which he had been given the award. While the scientist concerned is believed to have offered justification for the continuation of the award, the incident speaks of the upright character of Paintal.

It was during this period that Paintal, backed by scientists and others with similar concerns, founded the Society for Scientific Values (SSV). It was the forerunner of many similar organisations in the world of science. He regarded his activities upholding ethics and values as his greatest contribution to Indian Science. In his address at the Burdwan University convocation in 2001, Paintal said: "While there are exceptions, the Indian scientific community has yet to evolve a tradition... (with) a healthy scientific environment free from prejudices, bureaucratic formalisms, dishonesty, propaganda of unsubstantiated research claims, suppression of dissent, showmanship, sycophancy, political manipulation and manoeuvring. For this, it is of utmost importance to promote, by personal and collective efforts, the ethics and norms of science not only for the progress of science and technology in the country, but also for national character."

The very first general body meeting of the SSV saw Paintal taking the bold step of writing to the editors of three Indian journals that had published back-dated papers by a top scientist in the field of high-temperature superconductivity. Paintal sought the actual dates of submission of the papers and established that the means were illegitimate. He wanted the papers to be withdrawn, but unfortunately, the matter ended with a weak and unconvincing rationalisation by both the editors and the author.

AS president of INSA and SSV, Paintal castigated the U. S. administration "(for) the encouragement given to one of our agricultural scientists after it had been fully established that he was using fraudulent results for promoting himself and for getting honours in India and abroad." Paintal added: "After reading through the evidence, I have the impression that Dr. [Norman] Borlaug, who has been a key adviser, must have been misled." As president of the SSV, Paintal also led a team of scientists to the Himalayan region to investigate the internationally infamous fossil-fraud by a Punjab University geologist. His investigations established that the whistle-blower, Australian scientist John Talent, was indeed right.

Writing in Current Science on `Accountability in Medical Research' in 1994, Paintal raised the serious issue of the accountability of the members of ethical committees, which approved clinical trials of drugs and vaccines with potential harmful side-effects under political and other pressures. He pointed out how as the Director-General of the ICMR he came under intense pressure to approve the trials of an undesirable drug. He also highlighted the case of the then ongoing clinical trials of an anti-fertility vaccine, which, he felt, were unethical because of its known harmful side-effects and pointed out that no one was being held responsible. The trials had apparently been approved by the committee on the grounds of a similar vaccine being tried out in the U.S. But his inquiry with the appropriate U.S. authorities, however, revealed that no such trials were being conducted there. He pointed out that 20 years earlier similar "scandalous" trials on a preliminary anti-fertility vaccine, had been undertaken without even performing the minimal Phase 1 trails for toxicity and safety. Today, even as several instances of unethical clinical trials have surfaced and the administration has failed to make anyone accountable, there is a move to allow clinical trials to be conducted much in the manner of business process outsourcing (BPO) operations. The authorities would do well to pay heed to Paintal's words and first prioritise accountability before proceeding head-long in that direction.

Paintal's days as ICMR Director-General were also those in which the grave problem of rapid rise in HIV/AIDS infection in the country began to stare us in the face. He was extremely concerned about the issue and his remarks generated a great deal of controversy. The ICMR's early surveillance data suggested that the infection had entered the country through visiting foreigner clients of sex workers in the port cities of Chennai and Mumbai and was largely spreading through the heterosexuals. Besides spreading awareness through the media, Paintal, in his efforts to contain the spread, advocated abstinence and apparently suggested draconian legal measures that would forbid Indians from having sex with foreigners and Non-Resident Indians (NRIs). Naturally, Paintal came under severe attack and criticism from many quarters.

But Paintal, it would seem, was greatly misunderstood. His genuine concern for the problem seemed to have prompted him to make such extreme statements; it was a bid as much to attract the attention of the sexually active young and spread awareness about HIV/AIDS as to initiate serious discussion. In 1988, in an interview to the popular science magazine 2001, he said: "I do not mind if the message makes the D.G.-ICMR look foolish or whatever... But the message must get through. I am not bothered about by the amount of tomatoes that people have thrown at me. I say that every bad thing written against me, about me, means a thousand readers. If you say D.G.-ICMR is a marvellous person, nobody is going to read. If you say he is the biggest ass on earth everybody is going to read."

He had reiterated this even at the more serious forum of the INSA. In his presidential address, he said: "The suggestion by ICMR of controlling sexual intercourse with foreigners and NRIs has been discussed in newspapers throughout the world. One major benefit of this contribution by the press has been that in India now about 20 million people have become aware of the problem and now know that AIDS is an imported disease." As the country struggles with the mounting death toll from HIV and AIDS, Paintal's controversial views have come up once again in debates on the latest U.S. plan, the President's Emergency Fund for AIDS Relief (PEPFAR). This is exactly what he would have wanted. He once said: "I would like it [his suggestion] to be considered seriously... it has to be debated. I always believe that whatever I suggest or an idea that I have is wrong. I start with that assumption. Whatever experiment I do I always think it is bound to be rubbish, because when I do not succeed I am not disappointed."

In fact, developments in physiology in the past four decades have unambiguously demonstrated that his research in neuro-physiological receptors was more often right than wrong. Indeed, Paintal had started out his research career by proving his supervisor David Whitteridge at Edinburgh wrong with regard to the location of B-receptors. He may have been off the mark on social health issues such as HIV that transcends all cultural and geographic boundaries. But that only history will decide.