The release of the 2025 Human Development Index (HDI) report in May 2025 has highlighted India’s steady advance across global rankings. The index encapsulates the annual growth of 193 countries across health, education, and standard of living by evaluating their life expectancy, expected years of schooling, and gross national income (GNI) per capita, respectively. The 2024 report saw a substantial improvement in HDI score—the highest improvement recorded in India’s history—and recent index scores of 0.685 have complemented this, earning India a ranking of 130, up four places from last year.

India’s goal of becoming a high HDI country, i.e., an HDI score >0.7 is within reach; however, global growth in HDI has visibly plateaued for high and low HDI countries alike.

An important part of this growth for India has been the improvement of life expectancy by 23 %—from 58.6 years in 1990 to 72.0 years as of 2023. The United Nations Development Programme (UNDP) cites the varied national health programmes instituted by governments, past and present, in shaping this change.

The gross national income has increased by 6.7% over the past 12 months. The UNDP has previously acknowledged India Stack and the Aadhar platform for improving access to identity and payment systems, and ongoing government initiatives such as the Jan Dhan Yojana and digital inclusion programmes are furthering economic infrastructure to strive towards the 2047 high income economy goal.

Total literacy rates have improved, with the expected years of schooling remaining stagnant at 13 years; however, the mean years of schooling have increased from 6.6 years in 2022 to 6.9 years in 2023. The report makes a special mention of India’s leading positions in the utilization of artificial intelligence [AI], i.e., fourth in AI vibrancy and tenth on the global AI index. Braindrain and the loss of AI talent are slowly being combated with improved talent retention to 20% (previously nearly 0% in 2019).

However, other indices highlight areas that need improve- ment—30.7% of India’s HDI loss is attributable to inequality; 16.4% of the population remains in multidimensional poverty (a figure unchanged from 2022). While female representation in STEM (science, technology, engineering and management) fields is one of the highest in central and southern Asia, examination of the gender inequality indices still leaves much to be desired in terms of activity in politics and net participation in the labour force.

SAHIL SHAH, Wales, UK

ORCID iD: 0009-0006-5328-335X

On 15 May 2025, researchers from Children’s Hospital of Philadelphia (CHOP) and the Perelman School of Medicine at

University of Pennsylvania (Penn), USA, announced, at a meeting of the American Society of Gene andCell Therapy, New Orleans, their unprecedented success in treating an infant with a rare and life-threatening genetic condition, carbamoyl phosphate synthetase 1 (CPS1) deficiency, by timely and precisely customized gene editing therapy.

CPS1 deficiency is an extremely rare autosomal-recessive inborn error of metabolism affecting the urea cycle, wherein the liver is unable to fully break down protein byproducts, resulting in the accumulation of ammonia. It has a high mortality (almost 50%) in infancy, and survival hinges on a low-protein diet, supporting therapy with nitrogen scavenger medications, renal replacement therapy, etc., till the child is old enough for a liver transplant. Even so, during this waiting period, there is a high chance of brain damage, coma, and other morbidities.

The team of researchers led by Dr Kiran Musunru and Dr Rebecca Ahrens-Niklas sprang into action in a race against time and treated the infant, Baby KJ, in a remarkably innovative manner by making targeted nucleotide-level base editing correction within the living cells in vivo. In contrast to traditional gene therapy that inserts copies of functional genes carried by vectors into the recipient, they aimed to correct the defective DNA in situ and thus avoided insertion of exogenous genetic material. They accomplished this by using technology based on Clustered Regularly Interspaced Short Palindromic Repeats (CRISPR)-CRISPR-associated protein 9 (Cas9). Within 2 months of the diagnosis of the condition in the infant, the team developed a patient-specific cell line. It generated a mouse model based on the identification of the most precise base editing approach required for the specific mutation. They developed patient-specific adenine base editors and guide RNAs (as is done in CRISPR technology) for targeting the exact locus of defect on the gene. A lipid nanoparticle-based vehicle was utilized for infusing the guide RNA dose. With ethical and regulatory approvals, including the investigational new drug approval from the Food and Drug Administration, USA, and after testing in non-human primates and mouse models, the first dose was administered as an intravenous infusion to Baby KJ in the 7th month of life, and the second dose in the 8th month. Protein tolerance improved after the first dose of infusion, and further so after the second dose. No serious adverse events occurred. However, the researchers caution that longer follow-up is warranted to assess safety and efficacy.

It is also worth noting that the precision delivery vehicle was designed to deliver customized therapeutic RNA edits to the target organ, specifically liver cells, and potentially avoid affecting germline cells. This addresses an important ethical concern regarding gene editing therapy. The kind of vehicle (lipid nanoparticles) and intravenous administration gives the option of administering further doses should the need arise.

The work was supported by a grant for the somatic cell genome editing programme from the National Institutes of

Health, and also by in-kind contributions from industry and other agencies reflecting public-private partnerships towards the advancement of modern genetic therapeutics.

This achievement of customized/personalized gene editing therapeutics, in successfully treating the hitherto untreatable genetic condition in humans, with such speed and precision, has the potential to change the management of patients with rare genetic conditions significantly.

JYOTI NATH MODI, Bhopal, Madhya Pradesh

ORCID iD: 0000-0002-0626-1637

The Union Ministry of Health and Family Welfare has proposed, in June 2025, the launch of India’s first integrated MBBS- BAMS (Bachelor of Ayurvedic Medicine) degree programme at the Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry (https://medicaldialogues.in/ news/education/mbbs-bams-integrated-course-at-jipmer-to- span-over-5-years-154818).

The proposal aims to establish a distinctive pathway by integrating modern medicine and Ayurveda into a unified curriculum. The initiative has been described as an attempt to align medical education with a broader vision of integrative healthcare. JIPMER has reportedly prepared a draft syllabus in collaboration with the Auroville Foundation and Ayurvedic universities. The framework takes reference from the Competency-Based Medical Education model followed by the National Medical Commission (NMC).

As currently envisioned, the programme would run for more than five years, followed by a compulsory one-year internship. Graduates would be awarded dual degrees in MBBS and BAMS. The stated objective is to produce medical professionals with expertise across both systems of medicine, capable of drawing on the strengths of modern biomedical science as well as traditional Indian systems.

The proposal has sparked intense debate within the medical community. The Indian Medical Association and junior doctors’ associations have voiced strong opposition, warning that combining two fundamentally different streams could risk diluting training standards. Their concern is that graduates may end up insufficiently trained, raising issues of professional identity and patient safety. Critics have used the term ‘mixopathy ’ to highlight the dangers of combining medical systems with different scientific foundations, methodologies, and regulatory frameworks.

On the other hand, several Ayurveda organizations and practitioners have welcomed the initiative. They argue that such a programme could foster genuine collaboration between systems of medicine and expand treatment options for patients. They also highlight that integrative approaches are increasingly being recognised globally, with the WHO encouraging exploration of traditional systems alongside conventional medicine in specific contexts.

At present, the integrated course remains at the proposal stage. No formal approval has yet been issued by the National Medical Commission or the National Commission for Indian System of Medicine, which are the statutory regulators of medical education in India. Details regarding the final curriculum, admission process, and implementation timeline are awaited. JIPMER has not released official documentation of the draft syllabus, and further clarity on the structure and scope of the programme is expected in due course.

If adopted, this initiative would mark the first formal attempt to blend modern medicine and Ayurveda into a structured educational pathway in India. It would also represent a symbolic step in the Government’s larger policy emphasis on mainstreaming traditional systems of medicine alongside allopathy. The coming months will be critical in determining whether the proposal moves forward and how concerns raised by stakeholders are addressed.

The debate surrounding the JIPMER initiative reflects broader questions about the future of Indian healthcare—whether the integration of different systems can be achieved without compromising scientific standards, and how medical education can evolve to serve a diverse population with varied healthcare needs.

NISCHAL P.M., Mysuru, Karnataka

ORCID iD: 0000-0003-3491-5500

In June 2025, a newly discovered, rare, 48th blood group system was officially recognized by the International Society of Blood Transfusion (ISBT) (unofficially called ‘Gwada negative’).

This rare blood group was discovered in a woman from Guadeloupe (a French archipelago located in the Lesser Antilles, a chain of islands in the Caribbean; Gwada is slang for someone from Guadeloupe). In 2011, when this 54-year-old woman, from Guadeloupe, living in Paris had undergone a pre-surgery blood test, no donor was found suitable for her; during cross-matching her serum had reacted against every potential donor sample tested, including those from her own siblings. French scientists used whole exome sequencing and had discovered a mutation in the phosphatidylinositol glycan anchor biosynthesis class Z (PIGZ) gene that produces an enzyme that operates at the final stage of building the molecule ‘glycosylphosphatidylinositol’ (GPI). The missing sugar in the structure of a molecule on the surface of red blood cells results in a new antigen, and thus the discovery of the new blood group system: Gwada-positive (manifesting the antigen), or Gwada-negative (lacking the antigen). Further confirmation was done by recreating the mutation in a laboratory.

Earlier research had shown that persons with defects in other enzymes needed for GPI assembly suffer with developmental delays, seizures, stillbirths, etc. The patient, possibly the only person in the world with this blood group, has mild intellectual disability and had lost two babies at birth. These outcomes are possibly connected to this rare genetic mutation.

In an unrelated event, at the 35th Regional Congress of the International Society of Blood Transfusion (ISBT) in Milan, Italy, in June 2025, identification of a new antigen in the Cromer (CR) blood group system was officially named CRIB (CR representing Cromer and IB for India, Bangalore). This discovery was made in a 3 8-y ear-old woman from Kolar District, Karnataka, with O-positive blood, who was to undergo cardiac surgery; her blood group was incompatible with all available O-positive donor units. Further evaluation by Rotary Bangalore TTK Blood Centre and International Blood Group Reference Laboratory (IBGRL), UK led to the categorization of this blood group.

In addition, now, Rotary Bangalore TTK Blood Centre along with Karnataka State Blood Transfusion, National Institute of Immunohaematology (in Mumbai) and ISBT have established a Rare Donor registry.

Dr K.V. Sreedhar Babu, Professor and Head, Dept of Immuno Haematology and Blood Transfusion, Sri Venkateswara Institute of Medical Sciences (SVIMS), Tirupati told this correspondent, ‘The discovery is highlighting and reinforcing the fact that even low expression of undiscovered antigens can lead to life threatening transfusion reactions and transfusion of least incompatible blood is not suitable for all those whose blood is not compatible to any blood type where autologous transfusion is the only option left if transfusion of blood is required. The discovery is also highlighting the fact that even after centuries of scientific developments, surprises are there in blood science and also the importance of genotyping of blood which can lead onto discovery of yet undiscovered blood groups.’

ALLADI MOHAN, Tirupati, Andhra Pradesh

ORCID iD: 0000-0002-3214-9884