woman and child

Passages to India

Emory's strategic engagement in India traverses a wide range of disciplines to transfer knowledge abroad and bring globalization home.

Although Madhuri Hegde left Mumbai as a young woman, she has often returned to share her expertise in diagnosing rare genetic disorders during passage from India to New Zealand and finally the United States. As executive director of the Emory Genetics Laboratory (EGL), Hegde recently led an international delegation to convince the government to dramatically increase newborn screening in India, and in June, she will help run a national pilot for newborn screening there. Her Emory colleague, Rani Singh, professor and director of the division of medical genetics, nutrition section, will follow up with training on clinical treatments for babies diagnosed with life-threatening genetic disorders.

A comprehensive diagnostic and clinical lab for genetic disorders, EGL offers genetic testing for a full range of inherited genetic diseases such as Down's and fragile X syndromes. It uses cutting-edge technologies such as next generation sequencing for applications including disease gene panels and exome sequencing. It serves as the follow-up laboratory for the state of Georgia Newborn Screening Program, handling an annual case volume of approximately 30,000 samples. However, the impact of bringing this service to India could lead to exponential expansion of newborn screening -- close to 24 million babies.

"This delegation has established a formal partnership with WHO, UNICEF, the U.S. Embassy, and local advocacy groups and government officials on the ground in India, so that we can play a leadership role," says Hegde. "For me, it is a way to give back to my homeland. I feel like I owe something to India."

Hegde's aspiration finds resonance with other Emory faculty who come from India. Whether marketing guru Jagdish Sheth in the Goizueta Business School, epidemiologist K.M. Venkat Narayan in the Rollins School of Public Health, or vaccine researcher Rama Amara at the School of Medicine and Yerkes National Primate Research Center, these faculty with international reputations in a wide range of fields are transferring knowledge about India to the U.S. and in turn back to their native land. "My collaborations in India give me a sense of satisfaction to give back to a country that gave me so much, to share my knowledge and training," Amara says. These scholars are part of a large community of Emory faculty and students who have ties through research, study, teaching, and service to India.

The interest of Indian students in Emory is on the rise, with enrolling students from India more than tripling in recent years. For the class entering in fall 2015, India will send the second-largest international student group, thanks in part to increased efforts of Emory's Office of Undergraduate Admission to recruit in cities such as Delhi, Mumbai, and Bangalore. Recently the American Institute of Indian Studies rated Emory as a "Class A" university, making Emory competitive with other domestic strongholds that attract graduate students in Middle East and South Asian studies. Emory alumni chapters in India also are reporting tremendous energy and growing activity.

This growth is intentional, framed by the focus on global engagement in Emory's strategic plan, Where Courageous Inquiry Leads. While one could pick other countries and discover similar patterns of growth, expertise, and interest, India provides an interesting case study for how Emory is growing its reputation abroad and expanding its international reach.

For example, India is one of the five gateways identified for focused international activity in Emory's global strategies, a framework that will guide the university for the next five years. (The others are Brazil, China, Ethiopia, and South Korea.) "India was chosen not only for the number and level of activities but also the large engagement in a broad spectrum of areas," says Philip Wainwright, vice provost for global strategy and initiatives. "From the study of anthropology and religion in South Asia to collaboration on vaccine development, Emory's current engagement with India is among the strongest anywhere in the world."

Exploring private histories

A decade ago, Ruby Lal and Gyanendra Pandey arrived at Emory. Pandey already was a distinguished scholar and founder of the Subaltern Studies Group, a collective of scholars devoted to uncovering an inclusive history of India and the world. Lal, a South Asian scholar, came here from Johns Hopkins University to help build a Department of Middle Eastern and South Asian Studies. What started as a conceptual idea -- a humanities-based, cross-disciplinary area studies department -- is now a reality, says Pandey, with Emory being one of the few departments in the U.S. to offer an undergraduate degree in Middle Eastern and South Asian studies. The program draws on faculty expertise in archaeology, anthropology, gender studies, history, linguistics, literature, and religion to open up understanding of the region. And it is a leader in Middle Eastern and South Asian language education.

Through her books, Coming of Age in Nineteenth-Century India and Domesticity and Power in the Early Mughal World, Lal focuses on women and gender relations in the Islamic world. In an interview with Khabar, a leading Indian community magazine, she attributed "the incredibly rich, diverse, tolerant, and also contradictory aspects of India" as a motivator of her scholarship. In her next book, she will explore an empress of Mughal India, Nur Jahan, who is Shiite, married to a Sunni Muslim king, living a male-dominated world. She's interested in how the first part of the 17th century sees the rise of such a woman.

Pandey, Arts and Sciences Distinguished Professor of History, also is interested in the untold histories of marginalized social groups, such as the subalterns -- people who are denied access to many of society's basic cultural, economic, and political resources. In his book A History of Prejudice: Race, Case and Difference in India and the United States, he juxtaposed the civil rights struggle of African Americans with that of India's Dalits, or "untouchables." He did so by looking at public and private narratives to unravel some of the complexities of these histories. Now, Pandey is exploring primarily women's autobiographies to bring to light the private narratives of the U.S. Civil Rights movement. Using memoirs in Emory's Manuscript, Archives, and Rare Book Library, he wants to understand why an inner life is told the way it is and how that connects to contemporary historical movements such as the Harlem Renaissance.

Intertwining scholarship

Holli Semetko, Asa Griggs Candler Professor of Media and International Affairs, got a first-hand view of politics in India when she designed a post-election survey of the 2013 Delhi Assembly election campaign during her time in India as a Fulbright Nehru Scholar, based at the Indian Institute of Technology-Bombay. That work led to the 2014 India Election Studies (IES), supported by an Emory University Research Committee grant, which looks at campaign influences in urban India in national and state-level elections. The result was a "three-wave Delhi panel study to explain change," Semetko said at a panel discussion on faculty scholarship during Emory's 2015 India Week. Not only will the findings make their way into academic publications but also will serve as data for Emory graduate student projects.

Former U.S. Ambassador Marion Creekmore is another Emory professor who brings a personal view of South Asian politics to Emory students. In his course, South Asian Politics since 1945, he introduces undergraduates to the increasingly prominent role the region is playing in international affairs and shares his personal experiences of diplomacy to give context to policy-making in South Asia. Students in the class produce policy papers that outline a five-year plan for how a South Asian government might advance its key policy objectives. "I am an Indian citizen with an Indian passport who grew up in India," Pritika Gupta, 14C, told Emory in the World magazine while taking Creekmore's class, "and I do not know anything about the other side of the border, which is what makes me want to go to his class every day and learn something new."

Scholars Joyce Flueckiger and Sara McClintock of the Department of Religion served as advisers and editors for an online tour of the Michael C. Carlos Museum's Asian collection. The Odyssey Online: South Asia website enhances student learning and helps viewers more deeply understand the significance and function of these ancient artworks in a cultural context. The collection represents living religious traditions that originated in India thousands of years ago and spread throughout Asia and around the globe. Flueckiger plans to use the creative resource for Emory College courses that she teaches on Hinduism, performance, and ritual.

Arun Jones, Dan and Lillian Hankey Associate Professor of World Evangelism, offers students at the Candler School of Theology yet another passage to India, through the study of Christianity in Asia. He currently is researching an ecumenical history of India from 1800-1980. "I'm interested in the dynamic of how a foreign religion finds its place in the local scene," says Jones, whose father was a Methodist missionary from the United States to India and whose mother was from Calcutta.

Because of the way Indian societies function, the modernization of the country is fascinating, says Jones. "Westerners see it as developing in more a Western way versus the Indian way, which is to take things from the West and adapt them."

The rise of the new middle class

Speaking of the rapid modernization of India, meet the "call center couple." They are a young family. The husband and wife have college degrees. Both work to prosper financially and to reach their aspirations. They prefer that they do not live with their parents. They emphasize personal independence and freedom even more than previous generations.

The "call center couple" is a concept developed by Jagdish Sheth, Charles H. Kellstadt Professor of Marketing, to symbolize the rise of India's new middle class. "I believe the 'call center couple' represents a widespread, one-way, and permanent discontinuity from the past," says Sheth. He sees this new middle class as ushering in changes in values, opinions, and activities from previous generations away from an emphasis on extended family traditions to a narrower, nuclear definition of family.

So what do these shifts mean for India's future and its relationship to the global economy? Sheth sees India as emerging as a strong sourcing alternative to China. He is a strong supporter of "Make in India," an initiative of the newly elected Modi government. Since economic reforms in 1991, it has become one of the fastest growing economies in the world, accumulating more than $350 billion in reserves with a high-performing stock market. It has produced high-impact enterprises in industries from cell phones and IT services to Bollywood and diamonds that have combined market capitalizations "nothing short of spectacular," says Sheth.

He predicts that by 2025, India will be behind the origination of some of the largest global enterprises as well as become the second-largest consumer market in the world. He likewise sees it gaining in geopolitical clout. And, he says, one of the major resource advantages that India has going for it is a diaspora of more than 20 million non-resident Indians spread across the globe. Like Sheth himself, who left India to pursue opportunities in America, he says these individuals have thrived through hard work and entrepreneurship abroad but feel a loyalty to their country. "The motherland invested in me," says Sheth. "How can I contribute back?"

Sheth himself makes those contributions through active involvement in helping recruit Indian students and families to Emory and hosting a welcome lunch for new undergraduate students. Students such as seniors Armaan Sikaand and Saajan Patel, organizers of Emory's 2015 India Week, say that Sheth’s network gained them access to speakers for the celebration such as the writer of Slumdog Millionaire. The Sheth Family Foundation funds portions of business doctoral students' thesis research, has established the annual Sheth Lecture in Indian Studies, and endowed the Sheth Distinguished International Alumni Award.

Healthy collaborations

For K.M. Venkat Narayan, "global research should have mutual benefit. Some of the intriguing questions about health can't be answered in one place." To answer questions about diabetes and other non-communicable diseases, the global health professor draws on populations in the U.S. and India as leader of the Emory Global Diabetes Research Center. His collaborations bring research expertise from Emory to his home country and in return give U.S.-based investigators a large potential research cohort. He also has served as principal U.S. investigator of the NIH-funded Global Center of Excellence for Prevention and Control of Cardiometabolic Diseases in South Asia with partners in New Delhi and Chennai.

In April, a major global Center for Control of Chronic Conditions launched that brings together four institutes in Europe, the U.S., and Asia: Emory, the Public Health Foundation of India, the All India Institute of Medical Services, and the London School of Hygiene and Tropical Medicine. Its goal is to increase collaboration in research into non-communicable diseases -- and, Narayan adds, to encourage the "globalization of science." He sees the new center as an opportunity to uncover new causes of diseases that in turn will lead to the development of low-cost technologies to diagnose and treat those diseases.

At the root of all of Narayan's research is a desire to better understand who develops disease and why, along with the associated risk factors of diabetes and cardiovascular disease. India, Pakistan, and Bangladesh are among the top 10 countries with the most cases of diabetes. As a region, South Asia carries the burden as having the most diabetes-related deaths, and projections forecast that Asian Indians will account for 40 to 60 percent of global cardiovascular disease in the next 10 to 15 years. Narayan's multiple studies are following almost 50,000 people to glean a better understanding of those statistics so that prevention measures can be developed. In addition, his partnerships have trained nearly 60 people from India in non-communicable diseases, and through the PH-LEADER program, training in leadership and non-communicable diseases is reaching nearly 100 health professionals from India and four other countries.

Supported by Emory's strategic initiative to implement pathways to global health, professors are working on several ways into the country to make a difference from the Global Health Institute (GHI) to the Emory Vaccine Center, from schools in the health sciences to Yerkes.

For example, global health professor Usha Ramakrishnan, who directs the doctoral program in nutrition and health sciences, is working on improving the health of women of childbearing age by targeting nutrition interventions before pregnancy. In a broader sense, she says her work is about empowering women. "But it's a slow process," she says. "We're trying to change behaviors at all levels."

Rafi Ahmed, director of the Emory Vaccine Center, has set up a vaccine center in New Delhi in partnership with International Centre for Genetic Engineering and Biotechnology (ICGEB) with the help of an Emory Global Health Partnership Program grant. The center conducts vaccine research on infectious diseases of public health importance to India that disproportionately affect the developing world. Together, the partners have made progress on developing vaccines for malaria, hepatitis C and E, tuberculosis, and HIV.

Building on that work, Emory Vaccine Center and the ICGEB have received a grant from the NIH to study dengue virus infection in India. Dengue is a global epidemic with an estimated 390 million infections worldwide and nearly 100 million cases of clinical disease every year. India is emerging as an epicenter of dengue, so much so that it now has the largest number of dengue infections in the world, according to Murali-Krishna Kaja, an associate professor in the School of Medicine and the Emory Vaccine Center. "Currently there are no available antivirals or vaccines for dengue, thus there is a compelling need for a better understanding of the immunology and virology of human dengue virus infections."

Rama Amara, professor of medicine and a researcher at Yerkes, collaborates with three medical groups in India to gain access to a cohort for vaccine testing, on basic research, and research specifically related to developing an HIV vaccine. Supported by an Emory Center for AIDS Research grant, he has set up an immunology lab in India as well as training programs.

In May, the Bill & Melinda Gates Foundation announced a new global health surveillance network aimed at preventing childhood mortality in developing countries, particularly in sub-Saharan Africa and South Asia. Emory's GHI, which houses the International Association of National Public Health Institutes, is the lead partner in the network that will help gather better data, faster, about how, where, and why children are getting sick and dying. Envisioned as a 20-year project, this Child Health and Mortality Prevention Surveillance (CHAMPS) network will partner with governments and national public health institutes to better diagnose, characterize, manage, treat, and prevent disease. In the event of an emerging disease epidemic, CHAMPS also could be repurposed quickly.

According to Jeffrey Koplan, vice president for global health at Emory, "seven million children die from preventable causes annually around the world, and many of these deaths could be prevented." This network will concentrate on data to prevent, diagnose, and treat these children, from better vaccines and advanced medical procedures to improved nutrition and access to care. Shifting the paradigm to focus on why children in Africa and South Asia are dying can lead to evidence-driven priorities to reduce these unacceptable levels of childhood mortality, says GHI Director Robert Breiman. CHAMPS also presents a special opportunity for Emory faculty and students to participate in related research and training.

These forays into health, religion, politics, business, and history are just a few of the passages that Emory is traveling to India. Whether formal partnerships, student research fellowships, enrolling students from India, collaborative networks, or the desire of Emory faculty from India to give back to their homeland, these collective efforts are spreading Emory's desire to effect positive transformation in the world. As Madhuri Hegde sums it up, the ability to transfer knowledge about routine cases from our institution to there and to send fellows to train "is mutually beneficial. It has made the world come closer."

The Office of Global Strategy and Initiatives requests your feedback on ways to strengthen Emory's engagement with India. Please take this brief survey.

Photo credit: Billy Howard