Healthcare and Life Sciences in 2021: Part 1- Sectoral Investments Heat Map

2021 Healthcare and Lifesciences Investment Heatmap

Healthcare and Life Sciences in 2021: Part 1- Sectoral Investments Heat Map

Since 2013 our algos have been accurately predicting the investment heatmap in the healthcare and life sciences in India which were predicting with 95% accuracy on the sectoral investment cycle in India till the end of 2019. Covid Pandemic has completely disrupted and reset the investment cycle in India and we missed out all our prediction accuracy for 2020. We were at cross roads for releasing our Heat Map for 2021. The first was to actually abandon the whole exercise of predicting. The second was to actually relook at India and the world afresh and rebuild out algos and work with lower levels of prediction accuracy like we started back in 2013. We chose the later. While we worked on the Heat Map for 2021, we realized that there were additional variables that would impact investments in 2021 which we have added. These are Human Capital and New Normal Disruptions which would have an impact on how investments and investment activity in healthcare and life sciences in India will pan out in 2021. During 2020, while we were tracking the progress or containment of Covid to an endemic stage in India, we also realized that the execution of the Covid-related measures is in the hands of the States of India given that health is a State subject in our Federal governance structure and different States have demonstrated varying levels of outcomes in healthcare. My blog Sustainability of Digital Health | Kapil Khandelwal (KK) provides this insights. We have taken these into consideration to create for the first time State-wise investment Heat Map under Part 2, Hottest States to Invest for Healthcare and Life Sciences. These have been aggregated into our overall Heat Map here. Please await the release of our Part 2 shortly.

As part of our revised Heat Map for 2020 released in mid-2020, we had predicted a V-shaped recovery for healthcare and lifesciences. March 2020 was the all-time low for the markets and BSE Healthcare Index. By 31 December 2020, the index was at all-time high. With the rapid bounce back of the equity markets, the pricing and returns for healthcare and lifesciences is now not going to be sustainable in 2021, given low cost of debt in India, other supply side challenges, proactive regulations such as Telemedicine Act, National Digital Health Mission (NDHM), PLI Incentives, two leading Covid vaccine candidates.

Vaccine Race and Human Capital to Determine Investment Bounce Back

The investment for the industry for bounce back into the new normal is anywhere estimated to be around INR 120,000 crores a good chunk of this is going to be spent on the vaccination program in India. Our heatmap provides the snapshot of how the investment cycle is gearing up with increased pipeline of deals and investment flows. Markets have already recovered and factored this in their pricing.

2021 India Healthcare and Life Sciences Investment Heat Map
2021 India Healthcare and Life Sciences Investment Heat Map

Based on the Heat Map 2021, we have updated our revised Heat Map of 2020 published in June 2020 with the addition of Human Capital and New Normal Disruptions. Let’s relook at the board trends for 2021 in terms investment activity and trends.

Healthcare Financing

Pay cuts, job losses, low interest rates, reduced household saving and speed for digitization accelerates the ‘India Stack’ to reach to the consumer faster with innovative consumer financing products. Innovation into financing products and services for consumer financing of healthcare will see a few more players emerge. Many existing players are reworking their value proposition and plan to provide innovative products and services thus increasing coverage in 2021. However, as new demand accelerates, risk underwriting is equally important to avoid delinquency.

  • 2021 Outlook: Very Hot
  • What’s going wrong: regulation, maturity to scale, right bite for the consumers, reach and penetration, debt financing costs, slower non-discretionary and elective healthcare spend, delaying of healthcare spend
  • What’s going right: India stack digitisation, consumer borrowing to spend on non-electives, immediate gratification, reduced household savings supplemented by borrowings

Medical Education

Key shortages of healthcare frontline workers was very apparent during the Covid Crisis and now for the vaccination program. The need for regulatory regime to upskills is still being reworked. Healthcare could be the key job creator. Regulatory reforms are urgently required to push digitization and newer business models for upskilling existing workforce. Many of the debt servicing issues of the sector continue to persist with a few more NCLT/bankruptcy cases. A lot more exits expected and churn in ownership of assets due to consolidation activity.

  • 2021 Outlook: Moderate
  • What’s going wrong: regulation, corruption, no vision, skill shortages, alignment to new age care, increasing debt burden, new age skills certification, funding dry up
  • What’s going right: skill demand, NCLT closures, digitisation   

Med Tech Innovation and Life Sciences Discovery and Clinical Development

Focus in 2020 for clinical development had completely pivoted towards Covid vaccines and solutions and of global scale. India-Shinning moment with the two vaccines being awarded the emergency approvals has heightened investor interest in India. Investments will be selective in opportunities for Covid related therapeutic solutions. Social innovation would be the way forward. On the human capital, renewed interest of scientists to return back to India like in 2006-07 outsourcing boom.

  • 2021 Outlook: Hot
  • What’s going wrong: innovation pipeline, IP regulation, regulatory bottlenecks on clinical development, newer skill sets for research and acceleration
  • What’s going right: Human capital, cost advantage, emerging social innovation models,

Pharma and Therapeutic Solutions

M&A and consolidation activity will spiked up. Digitisation will be a key driver in 2021 and beyond. Some social impact models to counter the bottom of pyramid need gaps are emerging. Will not get mainstream in 2021 as China substitution and supply chain issues need to be resolved urgently inspite of positive policy push.

  • 2021 Outlook: Very Hot
  • What’s going wrong: price controls, policy log jam, wrong product portfolio, innovation and scale up, global or China-level cost competitiveness
  • What’s going right: cost advantage, distribution infrastructure, digital business models, Government incentive programs

Healthcare Providers

Funding and liquidity crisis continue after the lock down. Newer delivery models and hospitals of the future with asset-lite strategy emerge as costs build up and prices remain under pressure. Huge churn in asset ownership and consolidation activity. There will be no major action on PPP front. The telemedicine guidelines accelerate digital business models.

  • 2021 Outlook: Hot
  • What’s going wrong: margin pressures, price controls, GST slabs rationalization on inputs, execution of programs on the ground, PPP in healthcare, supply and demand mismatch in micromarkets, debt financing costs, gun powder churn, operating cash runway, liquidity and working capital crunch
  • What’s going right: Digital business models augmentation, asset-lite models

Healthcare Insurance

Complete liquidity crisis due to moratorium of renewals till October 2020. Innovative models for healthcare payors emerge in India for the middle bulge of India Stack for the middle 500 million that are paying out of pocket. As loss ratios will further mount, insurance rate will go northwards. Innovative products and pricing still a distant reality with the regulator in India. Many of the digital healthcare insurance players have to scale back and reduce their human capital and now need to rebuild in 2021. Don’t expect any IPOs.

  • 2021 Outlook: Moderate
  • What’s going wrong: margin pressures, product fit to consumer needs, product approvals, loss ratios, slow pace of innovation, operating cash runway, human capital reduction, consumer offtake and demand
  • What’s going right: Consumer demand, digitisation 

Health Retail

Muted consumer demand and discretionary spending due to reduce disposable income will result in slower growth and GMV pick up. Valuations will be a key issue. Consolidation and acquisitions expected for some to survive and grow. VC and PE interest is still muted and reviving their commitments to those ventures that survived the pandemic situation. Consolidation activity will increase. No serious IPO expected in 2021.

  • 2021 Outlook: Moderate
  • What’s going wrong: regulation, maturity to scale, slower consumer spending, operating cash runway
  • What’s going right: Consolidation, newer cross-vertical innovative business models

Wellness

Discretionary consumer spending on wellness to pick up due to fear of Covid. Mass market moderately priced wellness products and business model innovation is still lagging behind. Post lockdown the growth has not be pre-lockdown due to consumer intertia. However, very innovative business models have emerged for the new normal. Investment activity is yet to pick up in 2021 as most of these ventures are in infancy.

  • 2021 Outlook: Moderate
  • What’s going wrong: regulation, maturity to scale, new mass market business models
  • What’s going right: newer cross-vertical innovative business models, Fit India

Alternative Therapies

The Babas promoting alternative therapies have been coming up with Covid related products and its controversies. MNCs and local businesses have entered in this segment affecting their market share and position. Consumers adoption to accelerate faster as these products become the only choice. In this sub-sector, we are witnessing some very interesting ideas for disruptions in the New Normal these are very much at the seed or angel investing stage.

  • 2021 Outlook: Hot
  • What’s going wrong: maturity to scale, consumer education and confidence, clinical research, new product development
  • What’s going right: discretionary consumer spending, newer cross-vertical innovative business models

Stay Safe and Happy Investing in the rest of 2021!

What’s the Fear of WhatsApp Privacy Policy and your Fearlessness of Your Healthcare Information on Aarogya Setu?

WhatsApp Privacy Policy

The Fear, The Fake and The Facts – The New Pandemic on Chats

Monday morning when I woke up there and switched on my phone, there were hundreds of messages forwards and group chats if we should delete out WhatsApp accounts and either move the group to a new chat platform called Signal. In the fear of not losing out of the connects in my WhatsApp Groups, I also downloaded the Signal App. However two times it crashed and was not able to connect with my contacts. Over the day there were the fake propaganda being floated against WhatsApp. Let’s understand, India is one of the largest cohorts of users for any App and with over 750 million smartphones such negative propaganda to move towards open App platforms so that those who want to propagate their malicious negative agenda to the masses. These could be in the form of the following:

  • Communal, news written with the intention of inciting religious and communal passion
  • Violence, Criminal and sexual.
  • Integrity and Authenticity
  • Questionable Practices and Rituals (Occult, Blackmagic)
  • Bullying and Terrorism
  • Misinformation (bank shutdown, currency devaluation, economy)
  • False Health Advisories, we see an uptick in these during the Covid-19 pandemic
  • Spreading false information about competition
  • Political misinformation
  • Satire
  • Propaganda
  • Personal Defamation

WhatsApp has been working proactively with Governments across the world to curb this and had in fact deployed an army of factcheckers of over 10000 to do so. It is well evident that of the malice that have floated through Facebook and WhatsApp during the recent CAA, Farm Bill, Sushant Singh murder, etc which can be classified in the points above. One pertinent question that I would like to ask. Why is the backlash against WhatsApp privacy policy the peak only in India? There is nothing against WhatsApp in other countries. A point to ponder as to why and who wants to bring WhatsApp down in India just because it has acted wisely and ruthlessly against the cronies. WhatsApp India (and not WhatsApp Inc from the US) made a public statement (its an India centric issue)

WhatsApps Clarifications on the Privacy Policy

WhatsApp issued a statement to clarify their stand. These are:

  • WhatsApp cannot see your private messages or hear your calls and neither can Facebook
  • WhatsApp does not keep logs of who everyone is messaging and calling
  • WhatsApp cannot see your shared location and neither can Facebook
  • WhatsApp does not share your contacts with Facebook
  • WhatsApp groups remain private
  • The user can set their messages to disappear
  • The user can download their data
  • The company, in its blog emphasised that this update includes changes related to messaging a business on WhatsApp, which it claims is optional.

WhatsApp’s official Statement shared by The Verge:

“As we announced in October, WhatsApp wants to make it easier for people to both make a purchase and get help from a business directly on WhatsApp. While most people use WhatsApp to chat with friends and family, increasingly people are reaching out to businesses as well. To further increase transparency, we updated the privacy policy to describe that going forward businesses can choose to receive secure hosting services from our parent company Facebook to help manage their communications with their customers on WhatsApp. Though of course, it remains up to the user whether or not they want to message with a business on WhatsApp.

The update does not change WhatsApp’s data sharing practices with Facebook and does not impact how people communicate privately with friends or family wherever they are in the world. WhatsApp remains deeply committed to protecting people’s privacy. We are communicating directly with users through WhatsApp about these changes so they have time to review the new policy over the course of the next month.”

Hence the issue is not for the normal consumer. Let me also voice your concerns around the privacy policy which I have read end to end and accepted should center around the following points which you should consider and then decide if you would like to use the WhatsApp chat platform or not

  • WhatsApp Message Policy
  • WhatsApp Encryption
  • WhatsApp Device and Connection Policy
  • WhatsApp Location Policy
  • WhatsApp Data Sharing with Facebook
  • WhatsApp Ads Policy
  • WhatsApp Minimum Age
  • WhatsApp Ban Policy

Those using iOS and Android phones have you not accepted something similar when you activated your newly acquired mobile phones permitting Apple and Google. So what’s the issue with WhatsApp? They are not a phone/device company? So go ahead and read your agreement with iOS and Android/Google on your smartphones once again and compare that with WhatsApp’s Privacy policy.  

WhatsApp Privacy Policy on Healthcare Data (if any)

Back in April 2020, we had engaged with WhatsApp India leadership to enable CovidBots for various states on the 108 and 104 helplines to reduce the call volumes on the command centers. We had interacted with the Government Relations, the Legal Head, WhatsApp India MD, Facebook India MD, Head of Partnerships. The first question off the bat from WhatsApp was that every Chief Minister of India was given an approved number to communicate to their citizens of their state on Covid, why a new service. The second issue pointed out by WhatsApp India was is the CovidBot similar to Aarogya Setu App. If yes, WhatsApp India would not permit such a chatbot. Now my question to all in India is, if you can provide your location data and movement to now an officially mandated Government App, WhatsApp was just not interested in allowing any of their partners to collect location data of the people of India through their platform.

The second issue around the healthcare data privacy that WhatsApp was concerned before they approved a CovidBot was protecting the identity and masking healthcare data of the masses and nothing should be allowed to go through their WhatsApp platform. As you may be aware WhatsApp is a US headquartered company and is legally bound by a much more stringent HIPPA Act which our Aarogya Setu would fail if it was implemented in the US.

The third issue with WhatsApp in allowing any healthcare chatbot was that they had to actually write and clear a global policy on healthcare during pandemics and emergency. Their global policy team at their headquarters actually. India was the first country that was approved by WhatsApp to roll out a CovidBot in the world. Then Israel and others followed.

My limited point to all the fear and fake has been that a company like WhatsApp (now Facebook) is equally concerned in allowing what is legally feasible on their chat platform through their WhatsApp for Business and Facebook handles while the local Aarogya Setu does not even meet a basic privacy filter. So why is there so much fear around your privacy?

Let me conclude by saying, when you buy an expensive high-end smartphone on Apple or Android platform, please decline their terms and condition. The expensive toy in your hand will just be a brick. Please throw that expensive brick in your hand to protest for privacy on Aarogya Setu at Shaheen Baug.      

Also Read: Coronavirus in India: ‘Facebook, WhatsApp seek more data than Aarogya Setu app’ – Rediff.com India News

Era of Dual Screen Smartphones – Changing the Way We Experience Digital Health

LG Dual Screen Phone

Era of Dual Screen Smartphones – Changing the Way We Experience Digital Health

My Hands-on Experience with Dual Screen Smartphone – LG Dual Screen Phone

Finally, I could lay my hands of on an LG Dual Screen Smartphone to seriously evaluate the digital health experience on one new emerging form factor for smart phones. Here’s my journey and my views on which smartphones stake up the best.

Product Developments and Experience From the Past

In 2008-09, Intel started prototying tablets for medical applications to promote their products for healthcare applications adoption. Intel’s products though ahead of the time, were still meant that the clinicians could only use them in the hospital settings. Fast forward to 2013-14, Apple introduced its new range of iPhones and iPads. One of the start ups that I had invested and mentored used Apple hardware to promote its apps and services to the doctors. The limitations of the Apple ecosystem to allow third party Apps and integrations led us to work around with a concierge model to support our doctors. However poor quality and customer support was the final nail in the coffin for Apple as far as I am concerned in 2016. https://www.linkedin.com/pulse/rip-bad-apple-kapil-khandelwal

With Apple out of the way, we collaborated with Microsoft and Samsung for our healthcare Apps. The journey has been very positive. Also the collaboration between Microsoft and Samsung affirmed out belief that the future would be driven by these with the launch of Microsoft Surface Duo and Samsung range of dual screen smartphones, the whole experience from the clinician and consumers for digital health would be a shift in the new paradigm. Apple is now practically dead as it has not shown its intent to move with the times and its innovation for which it was known for is lagging behind Microsoft and Samsung. Moreover from the customer point of view the price to features provided by Apple is very high and not affordable for the masses.

We have been working with Microsoft to ship a few of their Surface Duo phones to test the whole clinician and consumer experience on digital health. While we were waiting for this, we tested out the Samsung Galaxy range. Out of the blue comes LG which launched is foldable range of phones. Recently, I got a LG phone and rigorously tested it for such experience. The table below summaries the details and my verdict.  

Comparisons

Specifications Microsoft (Surface) Samsung Galaxy Foldable Phone LG Foldable Phone
Display
Size 7.3 inches 6.4 inches 8.1 inches
Resolution 2152 x 1536 pixels, 362 PPI 2340 x 1080 pixels, 19.5:9 ratio, 403 PPI 2700 x 1800 pixels, 3:2 ratio, 401 PPI
Technology Dynamic AMOLED OLED AMOLED
Screen-to-body 85.79 % 83.41 % 71.93 %
Hardware
System chip Qualcomm Snapdragon 855 SM8150 Qualcomm Snapdragon 855 Qualcomm Snapdragon 855 SM8150
Processor   Octa-core, 2840 MHz, Kryo 485, 64-bit, 7 nm Octa-core, 2840 MHz, Kryo 485, 64-bit, 7 nm Octa-core, 2840 MHz, Kryo 485, 64-bit, 7 nm
GPU Adreno 640 Adreno 640 Adreno 640
RAM 6GB LPDDR4 12GB LPDDR4 6GB LPDDR4
Storage 128GB (UFS 3.0), not expandable 512GB (UFS 3.0), available to use: 461.8 GB, not expandable 128GB, available to use: 102.8 GB
OS Android (10) Android 10, Samsung One UI Android 10
Biometrics Fingerprint (touch) 2D Face unlock, Fingerprint (touch) In-screen fingerprint
Rear Camera Single camera, Doubles as a selfie camera Triple camera Dual camera
Front Camera (in the fold) None 10 MP (Dual-Camera, Autofocus) 32 MP
Price to Spec Very High High Low

My Verdict   

Given the specifications above there is not much of a difference except Samsung fold has a single screen which is foldable. Dual screens allow for multiple clinical and communication Apps to be opened and hence offers very high ease of use. Given the price point at which LG has launched their foldable smartphones, the high-end clinical experience on digital health is very much affordable for the doctors and consumers alike. Personally, I have been testing my LG Dual Screen Smartphone for various digital health experience and its fabulous. So the race for the foldable smartphones has just become more interesting.

Disclaimers: The views here are personal. Microsoft Surface Duo is based on their product launch videos. Apple has been deliberately not included in the comparison as they have yet to announce the launch of their iPineapple range of foldable smartphones. My personal experience with Apple India Customer Service and Tim Crook in the past has led me to the forgone conclusion that Apple will die soon! I have already retracted all my articles, views and quotes in the media for Apple except the one mentioned here. Your reading my earlier views on Apple is at your own risk.

Estranged 2020 : My Song, My Life, My Way

A Day in the Life of KK

Estranged 2020 : My Song, My Life, My Way

2020: Early Warnings of Devastation

I started 2020 with a very positive outlook. Our investment heatmaps were indicating upswing in investment activity, term sheets in progress for investments, strong investment flows on the back of Sino-US trade blockade. By 15 March, it was clear that some Chinese bug has hit Indian shores and I started out moving back our teams to their home bases, talking to the authorities on the situation. On my birthday, just a day before the first 14-hour lockdown, I was working late in office to mitigate the risk that may be arising out of the business disruption. Then there was the forced lockdown preventing me to work from office. The start of the Financial Year 2020-21 was clearing going to be a devastating one for all due to the Covid pandemic. In the first week of April 2020, all the financial and business outlook turned negative and also I suffered huge financial losses never anticipated in my life as a result. It was a very depressing personal situation for me which I had never faced in my life. It was clear I needed to bouceback. Suffering losses is a temporary situation, letting the frame of mind to continue with being mentally ‘broke’ was just not acceptable to me. Clearly there were four key issues that I observed in Q1

  1. the volatility and pace at which the situations changed
  2. all plans and predictions went for a toss
  3. there was utter chaos and no one had a clear head and view to handle the complexity and solutions to solve it
  4. with more bad news, there was no view when things will bottom out

That’s when I started my journey of My Song, My Life, My Mantra, My Way, My Avatar.

2020: My Song

During my long walks during the first week April, I would listen to Bon Jovi’s hit Estranged, the lyrics of which went like this and my responses (in brackets)…

When you’re talkin’ to yourself (about your situation)

And nobody’s home (although at home with family in the lockdown)

You can fool yourself (that All is Well)

You came in this world alone (I am all alone fending for myself)

So nobody ever told you baby (nobody had a clue)

How it was gonna be (the lockdown and beyond)

So what’ll happen to you baby (rather be strong than helpless)

Guess we’ll have to wait and see (no way)

One, two

The nine minutes song played out the remaining nine months of 2020 of my life.

2020: My Life, My Nine Mantra

There 9 minutes of the song inspired me to write my nine mantras to bounced back and come out a winner in 2020. These were:

1.    Love Thy Self: No Self Empathy

Every one in my circle of networks was very scared and required empathy. How would you empathise if you are yourself shallow and lack self-love? The toxic energy in the environment that was flowing around just was not doing good to me. I need not be a victim of this toxicity. That’s when I decided to manifest myself with a new energy and to fight the situation, I need to be stronger physically, mentally, spiritually. I started out with a healthy diet and high-end nutraceuticals, doubled up on my daily walks, increased my heart points by 3 times and started drawing on positive energy. As a result, I was over 10 kgs down in weight, much fitter and well energized positively to empathise with the people

https://www.linkedin.com/posts/kapilkhandelwal_festive-covid-lockdown-activity-6734056517827354624-rpJv

https://www.linkedin.com/posts/kapilkhandelwal_fitness-googlemaps-activity-6614182548820062209-J_Mn

2.    Renewed Vision for My Future Avatar

My mission in life has always been how to make healthcare cheaper, better, faster. Healthcare for All | Kapil Khandelwal (KK). With my interactions and calls with our investors, there was confidence in what we were doing. In fact, we raised even more funds during May-June 2020 for healthcare investments. The critical issue at hand was what investment strategies worked in the past would work in the post-Covid era. It was time to rework and restrategise the vision for my future avatar. With the positive energies, I set fearlessly out my renewed vision with Josh, Jonoon and Jigar. My best is yet to come!  

3.    Focus, Focus, Focus

With the my Avatar 2.0, it was time to focus. I clearly had 24-hours in a day and many unfinished business and agendas. It was with the renewed focus, that I cut down that was not required through a VED analysis of my work load. Clearly three key agendas for focus emerged out of this which I set forth in my work, declining, regretting and pre-closing many ongoing commitments as a result. This helped me put my time to get the maximum impact and the outcomes that my new Avatar was to emerge out.

4.    Build the Safety Net and Resilience

My primary responsibilities during the lockdown was to ensure that my people and their families are not adversely affected. To build confidence in my people, I build a safety net and emergency response for any eventuality due to Covid. At the cost of selling off my personal investments at a loss, I ensured that my people had food on their table and committed to my renewed vision with confidence.

5.    Create Impactful Behavior and Environment

To rebuild the economy and our healthcare systems for the future, it was clear that capital and investments would be with empathy and impact along with positive investor returns. One of the unfinished business was to ensure that there was a holistic and inclusive regulatory framework for the Social Stock Exchange (SSE) in India. I had been part of the journey with SEBI from its inception and worked with our team to produce a white paper with several recommendations which is now being on the table for the final regulation.

Social Stock Exchange | Kapil Khandelwal (KK)

6.    Network like never before

Other than the usual networking activity virtually during lockdown, being an investor allows you access to world politicians, thought leaders, think tanks, industry bodies, academia and opinion makers across the diaspora. My time was well spent speaking with them and gathering their take on various issues emerging out of this world crisis. Over the last 9 months, I had 1×1 with over 200 folks. I really thank them for taking their time to talk to me.

7.    Guides and Mentors

I renergised my circle of guides and mentors and opened up communications where we discussed may of my fears and issues heart to heart. This provided me the inspiration for being a better leader for the emerging new world order.

8.    Inspirational Leadership

With the current crisis, the model of leadership that I demonstrated is lead from the front and demonstrating everything is possible with less to do more. The constraints-based parochial leadership was passe for my people whether they were in front of me or virtually.

9.    Communication and Feedback with the World

In order to guide my peers and folks in the industry, I launched a podcast series QuoteUnQuote With KK which quickly emerged as India’s leading business podcast globally. QuoteUnquote with KK | Kapil Khandelwal (KK). This platform allowed me a means to communicate to the wider diaspora and also gain feedback from the world on what they were thinking on the issues.

2020: My Way, My Avatar

When I look back what I started alone in 2010 leaving Cisco as the top-200 Executive and compare what I have emerged out of 2020, I see that my way for the last 10 years could have only taken me so far. 2020 pandemic and situation, forced me to estrange my previous avatar and reincarnate into a new avatar that will be strong and durable for the 2020s decade.

The strong motive and motivations for my new avatar will drive me forward in the new normal for the world. I thank all those who have been part of this journey in 2020 to make it possible for me.

Here’s wishing you all a healthy, wealthy 2021!

Science of Politics of Covid Vaccine in India

Covid Vaccine Politics

Background

India has finally developed a vaccine for Covid which was approved by the regulatory authority the DCGI and it now the front runner for production of vaccines in the world. This is a great moment for India’s scientific might and I want to congratulate all the scientists who have worked tirelessly to deliver this solution to fight Covid to the world. Let me tell you that having worked in the drug development industry and also on the boards of several pharma companies, and biotech industry policy making, all efforts of the scientists are guided towards drug safety and efficacy before the final vaccine candidate is commercially produced for the masses. In the last 24 hours, leaders of several political parties have placed their roles in shamming and shaming the Indian scientists on the Covid vaccines being approved by the regulators in India. Let me inform you that Indian scientists do not work for political parties, they work for the advancement of science and technology. In this blog, I want to debunk some of the politics going on around our Covid vaccine and the timing of their political statements

The Political History of Bharat Biotech

Bharat Biotech whose vaccine Covaxin started in 1996 in the Genome Valley in Hyderabad. At that time the Deve Gowda Government with the support of Congress was at the center and the Telgu Dessam Party (TDP) was ruling in Andhra Pradesh. Let me remind the leaders of Congress who have come out with some statements, why did your Minister heading the Department of Science and Technology under which Department of Biotechnology (DBT) comes in provide grants to such a company if you believed that today that company is a fraudulently and premature in producing a vaccine for Covid. Over the years under the Congress rule, Bharat Biotech received some many grants and awards from the DBT to further their development of various vaccines. Infact BIRAC an arm of DBT also owned equity in Bharat Biotech at some point in time for the funding that was provided to Bharat Biotech by the Congress Government. I had been associated with the DBT and the Principal Secretary, DBT during the Congress Government who I worked closely to deliver the Biotech Ignition Grant Policy to the nation. He was very appreciative of the work Bharat Biotech had done and achieved several milestones in its journey with several vaccines and patents.       

The Science into Politics – Way Forward

Rather than making baseless statements around the vaccines being approved, its time political parties appoint a Chief Scientific Advisor like they had Chief Economic Advisors in their party. The job of this Chief Scientific Advisor and his team would be to sieve through the clinical data presented to the regulators DBT, DCGI and other departments and raise scientific issues and challenge the science on the floor of both the houses of the Indian Parliament through their elected party representatives rather than make frivolous public and press statements outside the house. This would imbibe science into politics and allow for the ruling political party of the day to address any issues relating to the science of drug development through the right governance mechanisms of our Parliamentary Democracy.  All I must say here is: Dear Politicians, please do not debunk our Scientific progress for your political gains and headline statements for your parties and your social media impressions and eyeball. In the eyes of science, you all have been marginalized completely.

Jai Hind!

For more information on Covid Vaccine also visit:

Covid Vaccine | Kapil Khandelwal (KK)

Sustainability of Digital Health | Kapil Khandelwal (KK)

QuoteUnQuote with KK (kapilkhandelwal.com)

How can Social Media be Socially and Inclusive in Healthcare in the New Normal?

Social Media in the New Normal

How can Social Media be Socially and Inclusive in Healthcare in the New Normal?

With the recent US Government action on Facebook and the pace at which fakenews have been spread during Covid and now on the Covid Vaccine, I am tempted to share my earlier article on this subject.

Background

India is world’s second largest growing online population in the world after Brazil. Over the last one year, India witnessed a YoY growth of 31% in people going on the internet, making it the world’s third largest population on the internet. More importantly, this growth has been fuelled people using tablets and smart mobile to go online. However when we look at in absolute terms, only 73.9 million people were on the internet (less than 10% of India’s mobile connected population) of this only 86% of the population (63.55 million) is using social media. While the use of healthcare online grew by 17% last year, it is still lower than retail sector’s growth of around 80% last year. It is fairly evident that several vertical online and social media options have sprung up in India, which has led to the heady growth in retail social media in India. Social media is not about page views, eyeballs or clicks (see box – What is Social Media?). Healthcare is no exception to this, as social media platforms radically changes the nature of business relationships. While over $ 750 million was invested in social and online retail business models last year, why has online and social healthcare business models and solutions remained a laggard in India?

What is Social Media?
Social Media is different from other communication platforms and channels in four ways:
Content is generated and governed to a varying degree by the users
Communities connect people with common life experiences, preferences and interests
Information can be developed quickly and distributed broadly
Open, interactive dialogue and information sharing among media users is encouraged    

Top – 10 Need-to-Knows about Social Networking and Where It’s Headed
Social networking is the most popular online activity worldwide
Social networking behavior both transcends and reflects regional differences around the world The importance of Facebook cannot be overstated
Short Content and Microblogging has emerged as a disruptive new force in social networking
Local social networks are making inroads globally
It’s not just young people using social networking anymore – it’s everyone
“Digital natives” suggest communications are going social
Social networking leads in online display advertising, but lags in share of dollars
The next disrupters have yet to be decided
Mobile devices are fueling the social addiction

The Social Media Landscape

Today there are over 450 social networking sites globally and they collectively serve over 6.5 billion registered users. Nearly 1 in 5 minutes online is spend online on social media, with Facebook getting a lion’s share of the time spent on social media. Healthcare consumers are now starting to leverage social media globally and in India. However, healthcare decisions or dis-engagement at any point in time with the decision making process is a very complicated process and there are many factors associated with this in the social media usage. Nor this is about hospitals putting up their Facebook pages, doctors in India putting up their profiles on Linkedin or some surgeon’s putting up their videos of their procedures on You Tube. This fragmentation has led to assessing not only beyond Facebook, Linkedin, Google+, Twitter, Instagram and You Tube.

Understanding the 4Es in Social Media Usage in Healthcare

Enhance

These are players who enhance and push content into the social community. By seeding conversations and then enhancing it, healthcare companies create and perpetuate an ongoing focus group that can help identify opportunities to create, enhance and modify products and services for consumers. These also include tools that enable the social media networking

Engage

The are platform that are used by healthcare providers, payers and employers to communicate and create a dynamic interaction with their community of patients, members and professional affiliates

 Educate

There are several platforms where user generated content and shared learning supports improved healthcare.

Enable

Enabling consumers to take a lead role in finding, sorting and acting on health information.

There are over 40 different micro-segments from the 4Es for social media features and services that can be offered by different social media platforms in healthcare. This is where there is opportunity for Indian social media platforms in healthcare to emerge and grow out globally. Analyzing the marketplace for vendors marketing social tools related to healthcare and I found a wide variety of business models and

strategic approaches. Of the numerous healthcare-centric solutions, many are geared toward consumer use, most are small and a scant few have “platform features” where broad social initiatives could be supported.

Slide3

4Es of Social Media in Healthcare Representative Companies in India and Globally
Enhance LiquidGrids, Listenlogic, Pharmawall, Semantelli, Welltok, NodeXL, Gephi
Engage Shapeup, ExtendMD, FairCareMD, HealthCrowd, QuantiaMD, RN Rounds, Sermo, Wellness Layers, Healthcaremagic,
Educate There are about 150 players here in India and abroad
Enable Snapdeal, Groupon, CarePages, eCareDiary, FitBit, Digifit, Endomondo, Gamercize, HealthCentral, LivingSocial, ZocDoc, 15 sites in India

Roadmap to Business Models for a Social and Inclusive Social Media in Healthcare in India

As you will notice from the table above, there are handful of social media business models or platforms in healthcare that have emerged out of India even though there is a huge potential to tap the huge mobile teledensity of close to 900 million. We have tapped less than 10% of this, even though healthcare is an important part of the way people live, work and communicate in India. How do we create a similar platform for rural areas, where Internet platforms are not usable due to literacy, access, and affordability challenges? Building on from my work at the Health and ICT Minister’s Panel for Africa in the last decade. The key takeaways from my work in the emerging market with respect to healthcare, ICT and social media is that these business models will be successful only when:

Transparency

The transparency of activities is a key feature in social media; health is a subject affects private provider companies, public administration as well as consumers

Rise of ubiquitous participatory communication model.

Newspapers, urban spaces and television will all be supplemented with interactive social media applications.

Reflexive empowerment.

Healthcare empowerment through social media is mostly reflexive, i.e. it is usually based on a specific issue and temporary coalitions that engage in dialogue on the topical issue.

Personalization/fragmentation versus mass effects/integration.

Practices and services in the web can be tailored and personalized to almost every detail with the help of portable profiles. Simultaneously, social media opens vast potential also for enormous mass effects and integration.

New relations between physical and virtual worlds

Practices induced by social media, e.g. communication, participation, co-creation, feedback and rating, get more common in daily environments and in urban spaces.

Key Drivers to Social Networking

There are 12 key drivers that need to be broadly analysed for developing social networking business models in (see box) in healthcare in India and that can then be exported to other emerging markets. Every business model in social networking in healthcare would pick 2-3 key drivers to disrupt the social networking landscape as described earlier.

Slide4

Creating a Framework for Transformative Business Models in Social Media in Healthcare

Countries like Finland, Singapore are experimenting these models of social media networking for healthcare. There are several analytical tools being used to analyse this networking effect. One such tool is illustrated in the box below:

Slide5

Charting out and exploring the social network relationships

As we are increasingly surrounded by a by a sea of tweets, e-mails, blogs, wiki pages, videos, wall posts and different apps that enable the social networking. It is important for any new business model to map out these relationships to understand where the gaps are in the overall social network landscape (4Es given earlier). 

Not all social media networks include people as nodes. Some include content of interest, such as videos, images, or wiki pages. Increasingly, data from social media sites such as tags, comments, purchasing patterns, and ratings can be used to link related content together into networks. Viewing content as a network can help learners make sense of how individual concepts or experiences fit into a larger whole. They can provide a view that provides perspective on an entire field of knowledge so that information that is most relevant can be identified. The goal is to provide an overview on surgery, many of which can be used to help educate medical students, professionals, and consumers. It may be useful in finding relevant content and its relationship. Companies or educational institutions interested in medical content may use such a map to inform their decisions about what videos to post and how to carve out a unique niche in the existing information landscape. Or they may decide that their solution has a poor selection of videos on the topic of interest

Social Network Map of Surgery on You Tube

Slide6

Case Study: Gram Vaani: Taking Social Media to the Masses

Gram Vaani is voice based social media network accessible from ANY phone (not a smart phone connected to a EDGE or 3G network). They have developed the novel concept of voice based social media, wherein they enable people to express themselves and share information in voice through ordinary phone calls. People can call into our toll-free number and leave messages or listen to messages left by other people (post moderation). It has captive user base of 35,000 families, over 2,000 impressions made per day. This enables

  • bottom-up information sharing where people ask questions and others from the same community help answer these questions, or share stories and experiences, and
  • accountability by giving reports on the performance of government schemes, demanding better performance from local and state social welfare providers, and policy inputs.

Their network in Jharkhand has seen several cases where reports filed by people led to redressal action by the government departments including healthcare, and the platform is also used regularly for information seeking on agriculture, livelihoods, health and education, and even cultural expression through folk songs and poetry. They have ability to run sponsored channels and programs and to incentivize local entrepreneur networks to conduct social marketing. 90% community sourced content which includes local news, interviews and informational services, opinion on topical issues, guided discussions and campaigns, grievances and feedback on government schemes, cultural artifacts including folk songs and poems. 98% of the users of this social media platform is educated class 12 and below. This platform is also very interesting for a vertical health through rural social media application.

Slide7

Summing Up

India is a typical to many other emerging markets where social media has only penetrated the urban and the educated sections of the society, while over a large majority 90% of the mobile population is still not seen the face of the Facebook. Healthcare is now emerging as investments in retail sector have penetrated deeper into India. We need business models that can become the next twitter or facebook in India. Folks like Graam Vaani have demonstrated in a small way that they can bring social media to the mobile connected populations of India and emerging markets. It is time to look at the 4Es of healthcare social media and start building vertical healthcare solutions on top Creating a Socially and Inclusive Social Media in Healthcare in India

What Drove QuoteUnQuote With KK to be India’s Leading Business Podcast to the World?

Why this Blog Now?

I was on a call with Padma Bhushan Awardee Dr. Jagdish Sheth earlier this week to wish him on his 58th Wedding Anniversary. He was the keyman and inspiration behind starting QuoteUnquote . I was updating him on the progress of our of the show. He requested me to share this experience for others to learn and figure out. Hence I am posting this blog.

Visit to the Showroom

In 2008, iPod Mini was launched as a very innovative product by Apple. I was at the Ample Showroom at Forum Mall. The sales person showed me the benefits of iPod Mini that apart from songs there was something call talk shows called Podcasts. I bought the iPod Mini and a Bose headphones. The next 2 years before my I lost my iPod Mini from my car, I was introduced to the world of podcasts. There were no Indian Podcasts back then. So most of the Podcasts I heard during my morning and evening walks were from Harvard, Stanford, MIT and other US Universities on leadership and management.   

The Covid Affected CEO’s Self-Motivational Drive and Mental Roadblocks

Fast forward to April this year, the Covid lockdown and crisis created a sort of a mental road block in the minds of circle of CEOs in India and amongst my peer groups who I was talking with. The uncertainty, lack of experience in crisis management of this sort and driving their people and companies out of this was their deep concerns that they expressed to me one-on-one. This also made me think hard and wonder on the road ahead.

The Vehicle Design Template

One of my weekly board calls with Dr. Jagdish Sheth, I openly shared my feelings and empathy towards my peer group with him. That’s when he recommended to organized a virtual webinar for my peer group of CEOs to which he would address to allay their concerns and provide a road ahead given he was in touch with the PM and other folks in the power center in India. We started off with a Virtual Fireside Chat which he would moderate with a few global thought leaders and himself. That was the birth of our vehicle to address the Indian CEO diaspora. The launch date was set and we burnt our bridges with the world and a brave announcement to invite my circle of CEOs to attend this Virtual Fireside Chat free of cost and openly share their fears.   

The Vehicle Proto Type and Test Drive

 While we set about in motion inviting a few panelist for this Virtual Fireside Chat, we did not have a name of the model. In of our brainstorming sessions we called this QuoteUnQuote. While we could get confirmations with a few thought leaders, their calendar availability led to all sorts of logistics and vehicle assembly issues in our garage production shop. Last minute drop out of our key driver Dr. Sheth, made us think we should abbot the launch or defer it. I took the brave decision to be the back up driver and hosted my dear investment industry Dr. Mark Mobious on QuoteUnQuote. 750 industry CEOs and veterans attended the show. WhatsApp messages poured as feedback from them till late night. It may be believe that the test drive was successful based on the results of the direction it set out the roadblocks in the minds of the CEOs.

The Licensing Issues

One of the editors of a leading media house who had attended the QuoteUnQuote published a summary of our talk without any due reference and credit to QuoteUnQuote. This made me furious. Given the media industry’s blatant misuse and misrepresentation, I called up the Managing Editor of Business Standard and worked out a 4-episode deal to publish in their newspaper to further amplify the content from our virtual shows.    

Further Test Drives

While Dr. Sheth was freeing up his calendar, we went on with a few more test drives with the Gallup Chairman, who I had built up friendship since 2004 when he visited India to make an acquisition and start Gallup India. He had to apologize last moment as he was called on a major TV channel in the US to announce President Trumps approval rating. His replacement, Mohammad Younis, the Editor-in-Chief at Gallup filled up the shoes of the Gallup Chairman and the audience expectations. Dr. Jagdish Sheth followed up with his talk which further delighted the audience and built confidence in the CEOs.

The Virtual Vehicle Model Development and Configuration – Autonomous or Automatic or Manual Gear

By June 2020, the starving event management industry and its corporate sponsors had found a way to engage with their target audience virtually and blatant spamming of emails, SMS and WhatsApp on a daily basis for invites started pouring in. The personal time pressures, work demands and virtual webinar fatigue started to set in with my peer CEOs who yet sent out messages through their executive assistants on the next event to block their calendars. We were just not prepared to run our prototype in its current form to compete with the well-oiled big buck event management industry. On the other hand, requests started pouring in from the PR agencies to take their clients on our panel. This was not the intent or the drive with which we had started out. Our vehicle prototype design needed a drastic remodelling and a new drive. Back to the drawing board.

Uber or Ola?

The Indo-China relations escalations and PM’s Atmanirbhar bugle call was the back drop on which we set out for a model redesign. Uber was an American business model in India while Ola (I was an investor in Taxi For Sure seed stage) an Indian business for Indian, let us believe that our core audience was still the Indian diaspora and an Indian Ola-like though-leader with a global unicorn stature would better empathise with our audience in these increasing complex times rather than a foreigner Uber-like global thought leader to give an outside in view and perspective to issues . After several discussions with my CEO friends and those in advertising, PR, digital media, affirmed our belief that a desi podcast show giving the anytime, anywhere, anybody, anyways and anything experience is the way forward and would be available on-demand like the app-based taxi service to our core audience and also extend to the wider secondary audience.

Does Brand KK’s has the Audience Permission and License to Drive?

Our next challenge was who will be the host to anchor the show. Given the preoccupation of our initial star host, we zeroed into some of the celebrity hosts from the TV channels to take the mantle. However, their exclusivity to their TV Channels or other virtual events did not yield us any potential star anchor. The issue boiled down to can KK do it and carry it forward. It made me wonder if I am capable and would the core audience accept me or see it as a platform that would be a bragging of KK. Internally, I had to search what were my bragging rights to qualify for a successful show host if the podcast had to move ahead and the time pressures and demands on me. I had chaired industry bodies forums which has delivered the Biotech Ignition Grant Policy, Agri Reforms, Social Impact and Financial Reforms. After a few calls with my mentors, CEO club buddies, the consensus was that I should anchor and continue with the shows. After a few YouTube videos on podcasting and inputs from Spotify CEO and his team, I finally took the plunge to create the podcast. Now what do we call it?

Vehicle Brand and Launch

After a few creative iterations and ensuring continuity of QuoteUnQuote the consensus was to name the podcast QuoteUnQuote with KK with KK as the anchor host. For any new vehicle launch you need a you need a celebrity to premiere it. Given the Indo-China cross-border escalations at its peak, I called my dear friend Parag Khanna to come for the show which he gladly consented. The podcast show was launched with a huge India and International acceptance. Given the topic Parag carried, the first podcast delivered us over 1 million impressions. However the intent was for Indians by Indians. Here came the next challenge, how to market and go to more Indians?

Setting Up Indian Vehicle Distributors

There are many Indian podcast platforms. We went and tied up with Aawaz and Zee5 for hosting the show. Over the next few episodes the impressions multiplied 100x for each episode. Potential speaker requests and content request feedback started pouring in.

Periodic Maintenance of our Vehicle and Fuel Top-Up

Blessed with a strong analytics team and a Chief Evangalist Officer, our podcast vehicle came into the garage for drive-worthiness and fuel-top up. Every podcast show gave us insights on how the drive has been and what shifts in the gears are required. Armed with all the information and details from the last 10 episodes, our calendar for the next year and the drive for the 2021 was announced to the world and CNBC-TV18.

The Key Take Aways for any New Podcast Vehicle Launch

The dialogue from Dirty Movie, “Films work on 3 things, entertainment, entertainment, entertainment. However, for podcasts, my dialogue is, “Podcasts drive on 3 things, Content, Context and Commentator.”

KK on CNBC-TV18

Healthcare for All: Money for Nothing!

KK at Tedx Gateway

In 1998, we solved the food security in India as part of the Prime Minister’s Task Force on Food and Agri. We gave the PM the slogan

“Kisan Ugaye, Janta Khaye, Aur Desh Aage Badh Jaye”

20 years hence, India is facing a impending health crisis. This crisis is already so huge that moving forward would take away 25% of the household incomes due to people suffering from health aliments and lack of proper medical intervention. You may google on Kapil Khandelwal to get to many of my articles in public domain to get more details of what I am saying is to the magnitude of 25 lakh crores per annum.  Hence to achieve our target of $5 trillion economy, we would have to actually target $6.5 trillion. An uphill task!

The Government has announced world’s largest Universal Health Insurance Scheme last year to mitigate the risks. It’s still early days and supply side capacities need to be build to service this incremental demand for healthcare services which are cheaper, better and faster to address. The world and the jury out there is witnessing this to come to its conclusion on the outcomes.

Unlike food security, health security is a more local and systemic long-gestational issue to solve the different at the factors of production such as land, labor, capital at a macro level. While each of the factors could by itself become a Tedx presentation. Let’s look at the high-level each of the issues and the break-away from the past to a new healthcare revolution in India.

At a global macro perspective of India, at 1.35 billion population, India constitutes ~18% of world’s population. From here things become a bit trickier. We have world’s 21% disease burden. Ie. One sixth higher proportion of people falling sick.

Coming to land, We have only 2.4% of world’s land mass so like intense agriculture on land, we have to be intensive in land usage for all activities. We would need approx 0.01% of our urban land usage for health and well being purposes which are currently not adequately provided by our cities and town planners. Hence land availability is critically sensitive.

Talking about labour, as far as healthcare is concerned, India stats become adverse.  To adequately treat that, we are approx 13.5 million hospital beds short. This is not accounting for the 1/6th incremental disease burden our population carries. On the clinical manpower shortages, we just have around 8% of the total global labour force of doctors, nurses and healthcare workers to address the 20% of the global disease burden we carry with our people. We are short by 5 lakh doctors, 20 lakh nurses and 30 lakh short of other health workers. Fortunately, we are a net exporter of nurses to the world so we have to also back fill the gaps of nurses leaving out of India for those remaining in India. 

Coming to the capital to address these gaps, we require close to Rs 30 lakh crores or $430 billion to come to the global average of hospital beds. Another Rs 2 lakh crores or $29 billion is required to build capacity for healthcare manpower. Therefore the total investment is approx $460 billion. To give you the magnitude, 165 countries in the world had a GDP of less than $460 billion in 2018. Or spending all what RBI currently has in its forex reserves on healthcare and becoming what Pakistan is struggling today or the scenario when Manmohan Singh took over as Finance Minister in 1991. A financial health crisis of sorts! The education and health cess

Why do we spend this all $460 billion now? We can drip feed the country to fund this? There is a saying “9 men cannot make a baby in 1 month”. Similarly, students enrolled into medicine today will add incrementally to the workforce in next 4 years.  The silver lining is that this capacity building spend would lead to $1.45 trillion of additional incremental to the GDP after 5 years as 1 incremental bed capacity creates 28 jobs over its lifetime. In other words healthcare economy in India as a standalone would itself be #16 nation in terms of GDP.

Therefore to achieve this the new slogan should be:

“Kisan Ugaye, Janta Khaye, Kisan aur Janta Swasth Rahe, Aur Desh Aage Badh Jaye”

How do we achieve this all?

We need a total disruption and reenvisioing to way things are done in healthcare while still minimizing the scarce resources such as land, labour and capital but derive the maximum impact. Before I start outlining my plan, let me make my customary caveats and limitations and disclaimers:

  1. I am not God nor his Massiah
  2. Political, economic, sociological, technological factors and assumptions are all favourable towards achieving this disruption
  3. Human race does not become stupid enough to become self destructive that health and well being of others and self is no longer a priority
  4. I am leveraging my experience in setting up various disruptive healthcare business models in the past to scale this
  5. My current experience to manage India’s first healthcare infra fund

Let’s get started:

Healthcare labour and skill acceleration, I had in one of my articles on human capital in healthcare estimated we need atleast 1000 Infosys, TCS hard brick and mortar like campuses near the cities that can work with clock speed in churning the talent pipeline. Our investments in new age AR/VR technologies in healthcare skilling and up skilling shows that medical and judgment errors are reduced before actual on the job-training to be right skilled for clinical positions from day 1.

Based on our investments in India’s first asset-lite day-care surgery chain, and here is the 80:20 rule. 80% of all elective healthcare, ie healthcare that is not an emergency or urgency is delivered out of the top-16 most populated cities of India. It is in these cities we see high concentration of highly-skilled and specialised medical labour force as well as infrastructure which is world class and cutting edge is present. Currently, catchment for these places is around 150-20 kms. Data from Ayshman Bharat on the residence city of the patient and the target treatment facility delivering care is yet no available for us to reaffirm the care for the bottom 250 million population of India.  Next 10 years we require this to extend to 30 cities. We need to set up stand alone acute and urgent care centers across all districts and taluks which would be feeders these 30 cities medical hubs

Tech enabled emergency, drones, telehealth, home health monitoring infrastructure with 5G connectivity have to be developed. I can go on this. However this would by itself be another Tedx talk by itself.

Coming to capital. Perpetual cheap cost of capital is the need for the healthcare industry to accelerate development of healthcare infra. Monetising existing infra is the only way forward to provide this essential capital. Moreover new age construction and build technologies which develop hospital are available outside India be its adoption is very low here. Around $20 billion of FDI can flow to India very quickly provided the enablers are given to the investment manager and incentives to the investors.

This is the excerpts of my talk delivered at Tedx Gateway on 20 July 2019

KK at Tedx Gateway

Ending Endemics: My Learnings from Eradicating Polio from India

My Paul Harris Fellow Medal

Ending Endemics: My Learnings from Eradicating Polio from India

Background

The rumors, fake news and experts comments around Covid Vaccination has pitched. In China, the mass sentiment is that their Covid vaccine is not effective and is just a placebo. While in India there are concerns on the efficacy of the vaccines under development and their safety. As a result our Hon. Prime Minister, Narendra Modi has to address the nation around this issue. There was a similar safety concerns around the pulse polio program in Tamil Nadu and Karnataka back in 2010 which was being organized by Rotary International. A few kids has some effects from the polio drops in the adjoining district of Bangalore, Hosur in Tamil Nadu. I was part of the Rotary which was planning the campaign for polio to ensure that there was a maximum turn out. The rumours and fears of the people in Hosur would have an impact on the turn out in the bordering districts of Tamil Nadu near Bangalore.

Our Strategy and Learnings

Back then the power of social media such as Facebook, WhatsApp was not effective medium to reach to the rural masses. Our challenge was to communicate effectively with every household which had children in immunization age in our state on the safety, benefits and turning out for the polio drops. As Rotary was a not for profit organization supporting this initiative, we had limited budgets for the campaign. The jugaad we used was SMS to every mobile subscribers in the state. Airtel, Vodafone, Idea, Tata Docomo, Spice Telecom, Reliance Mobile Circle CEOs were reached out to provide pro bono three broadcast SMS, free of costs to support the Rotary Polio initiative. All the mobile operators except Reliance Mobile agreed to support the campaign. Through the broadcast SMS, we communicated with the masses on informing the safety and need for polio drops for the children; it was free of cost; inform on the date of the polio program; reminder on the polio program one day before and on the date of the program. The result of this SMS campaign was over 99% coverage and turnout in Karnataka for the polio drops for the children. While Tamil Nadu had around 80% turnout.

Armed with this information, I visited Planning Commission office in New Delhi on one of my visits and met with Dr. Salma Hamied and Dr. Jagendra Haldea. I urged them to make free broadcast SMS mandatory for polio program for all states of India through the mobile operators. This request was accepted and sent to the Ministry of Telecom and actioned immediately. Through this process, India was declared Polio free on 27 March 2014 by World Health Organisation. I was honored by Rotary International with Paul Harris Fellow Medal for organizing and pushing the campaign.

Ending Endemics of Covid in India: Getting the Covid Vaccination Program Logistics in Place

The Numbers

As per my estimate, on the demand side, around 800 million Indians will be covered in the Covid immunization program. I am assuming that there will be a boster dose also. Hence we would require around 1.6 billion in two phases along with the allied materials such as gauge, syringes, swabs, etc to be provided for distribution to every nook and crany of India. Unlike the polio drop which the Rotary volunteers could easily deliver, this program will required trained volunteers in delivering injectables. My estimate is that we would require any where between 50 million trained volunteers in injecting the vaccines throughout India. These need not be medical professionals. On the supply side of the four key vaccines under development for India, Serum Institute, Cadila, Bharat Biotech and a few others would be able to deliver around 1 billion doses through their ramped up manufacturing facilities. The issue is the last mile linkages and cold chain required to reach the masses. Around 10 key states have ready excellent cold chain and warehousing and reefer facilities. These constitute around 68% of India’s eligible population for Covid immunization by April of 2021. The challenge will be for the other states which would need to be ready by April 2021 in the cold chain logistics.  

Busting the Myths: Communication Mediums

During Covid, we have implemented Covid Bots on the National Health Mission’s program through WhatsApp. It was a struggle to get the policy change in WhatsApp as there was no such policy in WhatsApp in March 2020 at the beginning of the pandemic. India was the first country in the world to get the approval to go ahead from WhatsApp headquarters to implement such Covid Bots. I would like to personally thank WhatsApp India and Facebook India Government Affairs teams to be able to push this with their global headquarters to get a policy out and obtain such approvals for roll out of such CovidBots. These Bots can be upgraded to answers queries on the Covid Vaccine program to be rolled out in March 2021 rather than the operators replying to the queries on the normal 104 helpline. We already have the policy in place for the mandatory SMS in place. This would give us reach and coverage to around 800 million eligible population of India for the Covid immunization.   

For more details on Covid Vaccine Race and More: Please visit the Podcast Ending Endemics: The Future of Healthcare QuoteUnQuote with KK – Kapil Khandelwal (KK)

PHF Medal

Beyond the Farm Bill – Setting the Agenda for the Next Generation of Food and Agri Reforms in India

Farm Bill

Introduction

In 1998, when I was part of the Prime Minister Atal Bihari Vajpeyee’s Task Force on Food and Agri Management Policy, we present set of recommendations that would transform the sector and affect the overall food security of India. The 70-page report outlined the issues across the agri value chain. To align the country, we gave the slogan to the Honorable Prime Minister:

“Kisan Ugaye (farmer grows)

Janta Khaye (population feeds)

Aur Desh Aage Badh Jaye” (and the country advances)

The current Farm Bill which is being politically contested is just addressing one part of the overall agri value chain. Back then in 1998, over INR 55,000 crores of agri produce is wasted every year due to inadequate infrastructure to the latest estimate of INR 44,000 crores. This is hardly a dent over the last 22 years in curbing the loss of farm produce. Over the last 70 years of independent India, the so called ‘middlemen’ have not added value nor reduced the farm produce losses. However, this is not the purpose of my blog today. There were several recommendations that were put forth and accepted by the Government in 1998. Unfortunately, the political and administrative will and intent was missing. I would like to recall some of the key recommendations that would need to form part of the Next Generation of Food and Agri Reforms in India.

Setting Agenda for Next Generation of Food and Agri Reforms in India

India’s current agri output is around USD 300 billion and provides food security for one season. There are several items on the agenda to double this output to around USD 500 billion by 2030. These include reducing the number of Ministries and Departments that manage the agri value chain, to setting up the Next Green and White Revolution to increase productivity to global norms, investment in smart infrastructure and digitization of agriculture, funding agriculture, food processing to enable farm to fork, agri labour reforms amongst a few. Let’s discuss the important agenda items one by one.

Super Food and Agri Ministry

In the current Government, there are following Ministries across the food and agri value chain:

  1. Ministry of Chemicals and Fertilizers
  2. Ministry of Consumer Affairs, Food and Public Distribution
  3. Ministry of Agriculture and Farmers Welfare
  4. Ministry of Food Processing Industries
  5. Ministry of Environment, Forest and Climate Change
  6. Ministry of Animal Husbandry, Dairying and Fisheries

This is still a manageable number from over 14 Ministries in 1998. Compare this with a single Ministry of Agriculture, Fisheries and Food (MAFF) in the UK which manages the administration of the entire value chain.

Next Green and White Revolution in India

In 1998, we had outlined several recommendations that would lead to doubling of the agri productivity to reach global norms in various agri produce per hectare. Over the last 20 years there have been several advances in agri and animal husbandry technology which would need to be rolled out at the farm level to increase the produce on reduced land supply for agriculture due to increasing population pressure. These include agri biotech innovations, precision farming, multi-level farming, organic pesticides and fertilizers and so on. The issue of land fragmentation over the last 20 years have become fairly acute and as time elapses, would accentuate further affecting the productivity. Newer technologies and consolidation to intensify agri on limited land due to population pressure is to be developed. Lastly, the issues of climate and environmental change over the 20 years have become very visible and would need technologies and crop rotation to mitigate agri failures due to climate and environmental changes that are occurring rapidly over the last decade. My work with Department of Biotech (DBT) in setting up the Biotech Ignition Grant (BIG) Policy in 2011-12 was muted to enable innovations in agri biotech and start up to obtain grants to commercialize their concepts and innovation in this area.

Investment in Smart Infrastructure and Digitization of Agricultural Value Chain

There are several developments on the information technology front which has yet to be adopted by Indian agriculturalists. Several product innovation start ups are working on solving some of these issues. We would need to accelerate the adoption as well as new innovation in IoT and remote sensing, big data and artificial intelligence, smaller farm implements for mechanizing small farm holdings, robotics, full stack farm 2 fork digital solutions. In 1998, ITC’s eChaupal was drubbed as an innovative path and way forward for Indian agriculture. Times and technology have advanced by leaps and bounds. Indian agriculture must adopt these quickly and aggressively. This also brings another issue of digital education for the farmers and labourers in upskilling them in these new tools and techniques leveraging deep tech in agri.

New Age Food Processing to Enable Farm 2 Fork

In 1998, several recommendations were made to invest into the food processing and logistics to enable quicker movement of fresh produce from the farm 2 fork. A lot has been done in this front. However, the data on infra investments in this space show a skew towards the top-5 states of India. Another area of innovation is adoption of newer and latest food processing technologies with our ‘jugaad’ innovation including the cold chains and refers. The Covid vaccine distribution cold chain which would be an episodic exercise could be turned to alternative use post endemic in the remotest parts of India to create the linkages of cold chain.

Agri Labour Reforms

Several recommendations have been made to consolidate the farms and contract farmers into co-operatives and social enterprises. One of the steps in the right direction would be the Social Stock Exchange where these social agri enterprises can be listed and be professionally managed with transparent governance and funding. The other issue that is reskilling and employment generation for the displaced labour due to implementation of new age deep tech which would replace manual farm labour. We had recommended around 15% of undisguised labour to be migrated out of agriculture to other sectors for employment. During the Covid Crisis, Rural BPOs have grown over 10-fold, its these ideas for alternative employment generation and reskilling that needs to creatively addressed.

Finally, Funding, Funding, Funding

Apart from the Central and State Government budgetary support to the sector for funding and apex financial institution NABARD, in the last 20 years there were a few focused providers of risk capital to this sector which I can count on my finger tips. These included PE/VC offshoots of large corporate houses with interest in food and agri and multinational agri-focussed banks. I believe the ESG Funds, new age VCs and the Social Stock Exchange Regulations will provide newer players to step into this sector. One of the hang over of the last 20 years had been the accumulated gun-powder that needs to be monitised.

Why Food-Health Alchemy is the Need?

As an investor in core healthcare sector, why am I writing this to set up the discussions on food and agri reforms? Our learning from our investments in nutrigenomics venture was that the new age diseases and syndromes emerging in healthcare is the outcome of what we eat. The food and nutrition consumption basket of Indians has dramatically altered over the last 20 years since my Britannia days. The national well being of Indian population depends on the nutritional outputs from the food and agri sector. Therefore I may now like to alter the slogan which we coined in 1998 to

“Kisan Ugaye (farmer grows)

Janta Khaye (population feeds)

Kisan aur Janta Swasth Rahe (farmer and population remains healthy)

Aur Desh Aage Badh Jaye” (and the country advances)

For more recent update on the issue of Farm Bill and Agri and Agritech Reforms listen to QuoteUnQuote with KK – Kapil Khandelwal (KK) and Mark Kahn on The Future of Agriculture: AgriTech and Government Reforms