Prof. Sarman Singh
Director & CEO
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The
present Director of All India Institute of Medical Sciences, Bhopal, Prof.
Sarman Singh was born to the inerudite parents hailing from a very small
village of Aligarh, Uttar Pradesh. He did his MBBS from prestigious King
George’s Medical College, Lucknow, MD from Post Graduate Institute of Medical
Research (PGIMER), Chandigarh, and Postgraduate course in Epidemiology of
Infectious Diseases from world famous University of Michigan at Ann-Arbor, USA
and a course on International Research Ethics from Harvard University, USA and
Natal University, South Africa. He has worked at the All India Institute
of Medical Sciences, New Delhi from 1988 to 2018 at various positions.
Dr. Singh is an able administrator and hard task master and has good administrative and constitutional knowledge. He is now internationally acclaimed medical scientist with outstanding research and academic achievements. He has guided more than 20 PhD and MD students. Of the 15 PhD students, all are pursuing their career successfully – 7 in the USA, 2 in South Korea, 2 in the UK, 1 in Germany and 8 in India. All have received accolades in the form of best poster or best oral presentations in various national and international conferences and most of them have received travel awards from DST, DBT, ICMR, BMGF or from conference organizers. One student was selected by HIV trust fund (Geneva) to work at NIH for 6 months. His team received several research grants from Department of Biotechnology, Indian Council of Medical Research, Department of Science, and Technology, Council for Scientific and Industrial Research, NIH (USA), DFID, European Commission, Bill & Melinda Gates Foundation, WHO etc. Dr. Singh is voracious writer, dedicated researcher, loved teacher by his students, an able administrator, and a visionary. This is evident from his high citation index of 7400, i10 index of 143 and h-index of 42. The
main focus of Prof. Sarman Singh’s research has been on developing more
sensitive and cost-effective diagnostic methods for infectious diseases,
particularly those that are difficult to diagnose and treat. Towards this goal,
he has made several ground breaking discoveries in the field of pathophysiology
of visceral Leishmaniasis or kala-azar. He was the first to develop and
patenting a rapid and highly cost-effective diagnostic test for this disease. A
novel recombinant antigen (Ld-KE16) was prepared from an Indian strain of L.
donovani (Singh & Sivakumar 2003; Sivakumar et al, 2006)
((PCT/IN2003/000400) and the commercial rights of the test were transferred to
the M/s Span Diagnostic Pvt Ltd through the Department of Biotechnology, Govt.
of India. The company has made rapid diagnostic test (RDT) kits in various test
formats, which were dedicated to the nation by the Honorable Minister of Science
& technology, Government of India Shri Kapil Sibal on February 6, 2006 in a
glittering ceremony at the Press Club of India. These RDTs have made the
invasive and hazardous methods like bone marrow and splenic aspiration
dispensable at a very affordable price (Singh 2006). It is a matter of pride
that the diagnosis of kala-azar can now be made at a cost of less than Rs. 50
per patient in India using these trailblazing “Made in India” kits. These test
kits are exceptionally accurate with 100% specificity and 98% sensitivity.
The disease kala-azar mainly affects the poor and down-trodden section of our society (Singh et al, 2000). Till rapid tests were made available, thousands of poor in the states of Bihar, W Bengal and Uttar Pradesh were dying due to this disease because of non-availability of sensitive, cost-effective and point-of-care diagnostic methods. It may be mentioned that with the availability of this revolutionary test, the number of kala-azar deaths has come down significantly - thanks to the Government of India for their active surveillance, and free treatment combined with the RDT kit developed by Dr. Singh that played a pivotal role in the national kala-azar elimination program. This cutting edge technology is also saving of millions of dollars of the Indian Government every year on foreign exchange. This is the first ever-indigenous invention by a medical scientist, which has become an integral part of any national disease elimination programme. This invention received high appreciation and applauds from the WHO (WR-India, as chair of the award selection committee) in the BMJ Research and Innovation excellence award distribution ceremony while announcing the award to Dr. Sarman Singh. Beside
the above, this work has been recognised by the prominent science agencies of
India, notably the Department of Biotechnology (Product, process and
Commercialisation award); Indian Council of Medical Research (Dr. BK Aikat
Award); Medical Council of India (Dr. BC Roy Award); Government of Uttar
Pradesh (Vigyan Ratna Award); Indian Medical Association (Med-Achiever Award);
Delhi Medical Association (Chikitsa Ratna Award); Indian Society of
Parasitology (Dr. BP Pandey Oration Award); Indian Association of Tropical
Parasitology (Outstanding Researcher in Parasitology); Indus Foundation
(Innovation Excellence Award); Society for Immunology and Immunopathology (Life
Time achievement Award) and many more. The
issue of reservoirs of visceral leishmaniasis in India has remained dogmatic.
The dictum has been that only post-kala-azar dermal leishmaniasis (PKDL)
patients serve as reservoirs and there are no animal reservoirs in India, in
contrast to the well-known animal reservoirs worldwide. In a spearheading study
Dr. Singh working on the premise that in several areas where there are no PKDL
cases (Dey et al, 2007), the outbreaks or sporadic cases of VL do occur (Singh
et a, 2011). Furthermore, using novel PCR primers (PCT/IN2004/000395) his team
also found that VL and PKDL strains are genetically different and both strains
have differences in the anti-leishmanial drug susceptibility pattern (Mishra et
al 2011). Therefore, in a radical approach, his team investigated thousands of
animals in endemic areas as well as in non-endemic areas and found that goats
are very potent animal reservoirs of VL in India (Singh et al 2013). These
findings are bound to make drastic deviation in the kala-azar elimination
programme of India. The
whole genome sequence (WGS) of several isolates of Leishmania donovani from VL
patients has been sequenced, but it is a matter of pride that Dr. Sarman Singh
became the first in the world to carry out the WGS of the PKDL strain of
Leishmania. The sequence alignment data showed significant differences in the
genome of PKDL strain as compared to VL strains (Gupta et al, 2015). The WGS
also revealed a revolutionary finding that a major portion of a saprophytic
bacterial (Parvibaculum lavamentivorans DS-1) genome gets integrated into the
genome of PKDL strain. On the basis of this discovery new biological phenomenon
has been postulated, thereby this integration could be the triggering factor to
manifest the two strains differently (the viscerotropic form becoming
dermotropic). This landmark discovery also proved his old hypothesis, that
Leishmania donovani undergoes in-vivo hybridization to manifest as PKDL. These
findings will go a long way in the eradication of old dogma about PKDL. India
has distinction of having maximum cases of HIV, TB, and Leishmaniasis. In an
in-depth invited review in International Journal of Infectious Diseases Dr.
Singh discusses the current scenario of HIV-leishmania co-infection and factors
that contributed to help quell this duo, in contrast to the other co-endemic
countries (Singh, 2014). However, the Leishmania and TB both are co-endemic in
several parts of eastern India. It is also known that approximately 20% VL
patients will have concomitant or subsequent Tuberculosis but there is no
effective vaccine for these infections. Considering this as a major research
challenge, for the first time his team prepared a self-cleaving chimeric DNA
vaccine which can be used against both TB and visceral leishmaniasis (Dey et
al, 2008). This cutting edge innovation has been patented globally
(PCT/IN2009/000093). The department of Biotechnology who funded and licensed
this work, observed this invention as of high commercial value. The reputed
journal Vaccine invited him to publish this innovative research to publish in
their special issue (Dey & Singh, 2009) and again another reputed journal (Parasites
and Vectors) invited him to write a systemic review on Leishmania vaccines
(Srivastava et al 2015).
Miltefosine
is a new drug approved for the treatment of VL in 2004 only but within few
years of its introduction, the efficacy has gone down. To understand the
mechanism of resistance, in an avant-garde study his team has discovered novel
mutations in the genes of Leishmania; which impart resistance to miltefosine.
These mutations can now be used as molecular markers to diagnose and predict
miltefosine resistance in circulating strains at an initial stage (Srivastava
et al, 2016). Tuberculosis is the main killer infectious disease in India. On the top of that multi-drug resistant (MDR) and extensively drug resistant (XDR) forms have emerged forcing WHO to announce MDR-TB as health emergency. Dr. Singh for the first time reported high incidence of XDR-TB in Indian AIDS patients (Singh et al 2007). Though this publication created lot of discussion in Government, but finally it was accepted as realty and based on these findings Government of India implemented programmatic management of DR-TB (PMTD). Unfortunately early and accurate diagnosis of TB has remained a major challenge for researchers and programme managers. In last 20 years several serological test kits were dumped in the Indian market for the diagnosis of PTB and EPTB. But these kits gave highly inaccurate results, leading to unnecessary treatment to hundreds of thousands of patients, and leaving several thousands TB patients untreated. Dr. Singh played crucial role in getting these serological kits banned for import, manufacture and use in India (The Independent, UK; Times of India; The Hindu; Deccan Herald; Spectrum; etc.) and live discussion on the all India Radio. The Editorial published in the IJMR (Singh & Katoch, 2011) played the key role in this decision taken by the Government of India in May 2012. However,
the ban on serology has created a complete gap in the TB diagnostic field. Dr.
Singh worked untiringly to find out novel molecular tools and biomarkers for
the diagnosis and differentiation of drug susceptible and drug resistant
Mycobacterium tuberculosis. His laboratory has recently made a revolutionary
discovery in this field. After screening hundreds of proteins of MTB, his team identified
5 novel proteins/antigens, which are over-expressed only during the in-vivo
drug resistance development. The genes were cloned and proteins expressed,
purified and used on various categories of patients showing the sensitivity and
specificity of these proteins between 98.2% -100% and 89.1 - 98.2%,
respectively (Singh et al, 2015, Singh et al, 2016*). Using these novel
proteins development of a point-of-care (POC) rapid test is underway. This
innovation will be a game changer in the area of TB diagnostics not only for
India but globally. The Foundation for Newer Innovative Diagnostics (FIND) has
shown interest in this innovation and very soon this innovation will make India
proud of innovative research. He has also used his epidemiological skills acquired
during his training at University of Michigan (USA) and has done various field
studies. He has formed a network of scientists working on Tuberculosis in
India. In a spearheading study his team screened 628 isolates of MTB collected
from various parts of the country, genotyped these and did drug susceptibility
testing to uncover how the socio-geographical factors influence the prevalence
of various genotypes of MTB. This was unique and first study of its kind. The
Beijing genotype of MTB, which is most prevalent in NER-India is having highest
vulnerability for drug resistance while EAI genotype (found mainly in South
India) having least preponderance for drug resistance (Singh et al, 2015). In
this study he for the first time successfully documented the impact of
population migration on the prevalence of various mycobacterial genotypes in
different. This study was judged as the best study of 2015-16 carried out at
the AIIMS and Dr. Singh was awarded First Prize in Research Excellence by the
hon’ble Minister of Health and Family welfare, Government of India, Shri J P
Nadda. The study has got wide coverage in the print media and Department of
Biotechnology (NER-BPMC) has announced a special call for proposals to deal
with this menace. Recently his team proposed to make use of phantom drones to
control drug resistant tuberculosis in North-East Region of India. The proposal
is being actively considered by the central TB division of Ministry of Health
& Family Welfare, Government of India. Dr.
Singh has also done pioneering work in the field of non-tuberculous
mycobacteria (NTM) often neglected by clinicians and medical microbiologists as
contaminants. In AIDS era these NTM have gained much importance but the
conventional methods of identification are neither reproducible nor very
specific. His team has developed novel sets of multiplex-PCR primers for the
diagnosis and differentiation of Mycobacterium tuberculosis, M. avium, M.
kansasii, and other NTM, directly from the clinical samples in a single tube
(PCT/IN2004/000396). These PCR primers and the process have been found highly
sensitive and specific and are being routinely used at AIIMS and many other
laboratory settings throughout the country (Singh et al, 2006, Gopinath et al,
2009, Kumar et al 2014a). The PLoS Neglected Tropical Disease published Dr.
Singh’s “Personal Opinion: on this subject, which is highly cited. This has
made a paradigm shift in the understanding of NTM disease in India. Using the
same gene targets, a new technology known as loop mediated isothermal
amplification (LAMP) assay has also been developed by him with a commercial
partner (Kumar et al, 2014b). The technology is being evaluated across the
country and soon may be taken up by the Government of India. Currently
molecular tools have become essential to understand the pathophysiology and
drug targets. Dr. Singh has moved with the time. His laboratory is equipped
with all modern tools including 6-laser flow cytometer and New Generation
Sequencer (NGS), beside all routine diagnostic tools and services. His
laboratory caters diagnostic (routine and specialised) tests with precision and
accuracy. For his quality services his laboratory is recognised as training
centre for whole Asia region for new TB diagnostics by the Stop-TB division of
WHO (Geneva) and also by the central TB division of Government of India. Prof.
Singh is the sole authority in the field of Toxoplasmosis in India for both
medical and veterinary fraternity. His Toxoplasma reference laboratory is the
only centre in entire India, which is maintaining and distributing the
Toxoplasma gondii strains to other researchers for the last 26 years
continuously. Because of his spearheading teachings through webinars, print
media and on other platforms including the FOGSI, ISP, IATP, IAMM, etc he has
been able to convince the majority of Gynaecologists, Obstetricians,
Paediatricians and Medical /veterinary microbiologists of India, that bad
obstetric history (BOH) is a misnomer and that Toxoplasma causes multiple
abortions is only a myth (Singh 2003; Singh & Pandit 2004; Singh et al,
2014). He is now the last word for Gynaecologists and Obstetricians of India
regarding the diagnosis and management of congenital/antenatal toxoplasmosis.
He has saved several unwarranted terminations of precious pregnancies suspected
to have intrauterine toxoplasmosis on the basis of inaccurate test methods. His
work has been cited in several reputed reference and text books-notably, the
Infectious Diseases of foetus and neonates (Remington & Klein), Practical
Obstetric Problem (Ian Donald); Toxoplasmosis: A comprehensive Clinical Guide
(David et al), International Encyclopaedia of Public Health (Academic Press);
Practical Guide to high-risk Pregnancy and delivery (Arias); Internal Medicine:
an Illustrated Radiological Guide (Tubaikh) to name a few. It is worth
mentioning that for his work on Toxoplasmosis he has been honored by the
Indian Academy of Tropical Parasitology as well as by the Indian Society of
Parasitology. Beside TORCH infections his original work on mother-to-child
transmission of Hepatitis E virus has been cited in almost all text books of
paediatrics and Obstetrics, for examples – Principles and Practice of
Infectious Diseases (Bennett et al); Infectious Diseases of foetus and neonates
(Remington & Klein); Practical Obstetric Problem (Ian Donald); Viral
Infections of Humans (Kaslow et al) and Avery’s Neonatology. He
was the first to document first case of HIV-Leishmania co-infection in India
(Singh et al 2000a) and also high incidence rates of hepatitis B and Hepatitis
C virus infections in Kala-azar patients of Bihar who were receiving multiple
injections of sodium antimony gluconate (Singh et al, 2000b). He for the first
time documented that circumcised patients had lower incidence of Hepatitis C
and HIV virus infections in India. The WHO noticed these findings and its Safe
Injection Global Network (SIGN) division organised a special meeting with
Government of India (in 2001) and highlighted the need for safe injection
practices in India. Dr. Singh was special invitee in this meeting to present
his findings. This advisory issued by the WHO to India based on his findings
changed the scenario of injection practices in India. As
a physician also he has contributed immensely in the Clinical Practice. For the
first time from India, he reported mucosal involvement by Leishmania donovani
in an AIDS patient and Prof. Singh coined a new clinical condition post-kala-azar mucosal leishmaniasis (PKML) and published in the Lancet (Singh,
2004). Other authors are now using this clinical term also (Singh 2014). He has
treated rare clinical conditions like genitourinary enterobiasis (Singh et al,
1989), Scalp Phthiriasis (Singh et al, 1990), Hookworm granuloma of Gastric Os
(Singh 1999), Toxoplasmosis in an immunocompetent surgeon, and many more. He
has successfully carried out clinical trials of herbal immunomodulators in AIDS
patients. He is running a pre- and post-test counselling clinic for HIV/AIDS
and TORCH infections for the last 20 years and supervises more than 5 lakh
investigations each year. Indeed
Dr. Singh has several firsts to his credit, whether it pertains to new
discoveries, novel innovations, finding new pathogens, clinical conditions, or
disease manifestations. His keen interest in new discoveries and scientific
dissemination started from his early residency days at PGIMER, Chandigarh. Dr.
Singh was the first to report fungal contamination (Trichosporon beigelli) of
UGI endoscopes instead of routine decontamination procedures (Singh et al 1989).
This work has been cited in almost all textbooks of Gastroenterology. He also
reported new species of Trichuris (vulpis) in Onges tribes of Nicobar (Singh et
al 1993) and new genotypes of Mycobacterium tuberculosis in India. In addition to research, teaching and patient care he is helping various Government organizations like UPSC, DBT, ICMR, ICAR in the academic and administrative processes, and on being on their task forces. Dr. Singh has been member of Peer Team of NAC and Inspector of the MCI. Dr. Singh has also been on the research advisory committees/examiner of more than 25 central and state universities. He is also member of scientific advisory committees of JIMPER, Pondicherry; RMRC, Jodhpur and National JALMA Institute for Tuberculosis. He is grant reviewer for DST, DBT, DHR, ICMR, CSIR, BIRAC/IKP, BCIL of India. His research is also recognized outside India and he is grant reviewer for Medical Research Council, Government of South Africa; Ministry of Science and Technology, Life Sciences Division, Government of Israel and Ministry of Health (General Director for Scientific Research and Health Innovation), Italy. He is also abstract reviewer for World AIDS conference (IAS, Geneva) consecutively for 9th year and also for CROI (USA) and ICASA (South Africa) for last 3 years. He
is one of the upper 10% peer reviewers of publications from topmost publishers
like Elsevier (including Lancet), NPG, Bentham, Springer, ASM, JAMA, BMA and
others. Overall he is manuscript reviewer for 41 reputed journals while
refusing review requests from hundreds of online journals. |
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