GYAN GRAM Knowledge City Creating India’s Knowledge Cluster
General Director & Project Coordinator Javier Jileta Edition Javier Jileta Jorge Cabrera Román Meyer Eduardo Castro Research & Content Development José Carlos Barranco Alejandro Cabrales Abraham García Kenneth Lazo Luisa Mancera Jorge Luis Salas David Sánchez Translation Kenneth Lazo Luisa Mancera Art Direction Eduardo Castro Design Eduardo Castro Danira Espinosa Romina Rivera Photography Shutterstock Ilustration Emilio Cantón Renders Alejandro Cabrales Román Meyer Daniel Ceceña Alberto Lara Reproduction of all or part of this work by any means, including electronic, is prohibited without the express permission from the copyright owner. Copyrights of the published texts are the property of Cientika, AC, unless otherwise specified. The US Dollar amounts published were calculated on the Exchange rate in effect as of May, 2012. Most amounts may be rounded in order to facilitate Reading comprehension.
GYAN GRAM
Creating India’s Health Knowledge
Health Cities one are where a knowledge economy can be focused to leverage human capital and sectorial collaboration to bolster a strong health sector
GYAN GRAM Knowledge City Threshold for Indian HealthCare Future
The 21st century is one of opportunity. There has been no other time in history with so much talent, creativity and will to change the world as there is now. Collective knowledge is today our strongest tool to undertake innovative, sustainable, transformational projects. India is known for creating an environment conducive to getting ahead. Necessity leads us to seek niches of opportunity and work towards the common well being of our entire population. In this sense, we have learned that knowledge and the act of sharing it leads us to a more effective dynamic in which we can have better ideas, complement those we already have and strive towards new horizons. Knowledge cities are centers for the production and articulation of ideas, a place where talent is created and shaped. They are spaces for interaction where society’s most important stakeholders work, relax and dwell as part of a greater, collaborative community. The investigative arm of the private sector and the government integrate to work towards one common objective: to share knowledge and work for the betterment of society. Knowledge economies will represent a milestone in this arena. These economies symbolize the beginning of a new era, not only nationally but also globally. We are already a part of a society with no borders. Seeking more and better collaboration is of paramount importance in order to achieve larger goals. Knowledge cities will bolster our economy and provide an outlet for our country’s most talented. Projects of great impact will materialize, allowing us to create better opportunities that benefit everyone.
CHAPTER
1
Knowledge Cities
CHAPTER
2
CHAPTER
3
Gujarat Knowledge and Health advantage
Health City Proposal: Conceptual Overview
12
What is a Knowledge Economy
24
India and Gujarat at a Glance
42
Land location
14
What is a Knowledge City
26
Healthcare in India
46
Contextual Study:
16
Knowledge Economies and Cities:
28
Healthcare in Gujarat
Concept Definition
30
Gujarat’s Healthcare Ecosystem
47
Urban Fabric
18
The Health City Concept
34
Gujarat: Main Causes of Death and Most
48
Program Components
20
Health Cities Around the World
Common Diseases
52
Healthcare Facilities
36
Gujarat: Medical Tourism
56
Commerce and Office Facilities
38
Health Care Market: brief conclusions
60
Education and Residential Facilities
and business opportunities
62
Light Industry and Basic
The land and its surroundings
Service Facilities
INDEX
66
Public Spaces and Amenities
67
Green Area and Nature Reserve
Health Cities will leverage human capital and sectorial collaboration to bolster a strong health sector
WHAT IS A KNOWLEDGE ECONOMY? In the last few decades, the most advanced economic models have moved away from industrial production and services and moved towards the creation of wealth through less tangible means. This emerging structure is called a knowledge economy, characterized by its use of technology and information to generate value and wealth. Strategies focused on strengthening education, sciences, industry and new technologies are common.
Knowledge Cities
Knowledge Pentagram* Access to Knowledge
The Knowledge Paradigm
ICES SERV
S
A knowledge-based economy has to constantly look to the future in order to strengthen the present abilities, capacities and adaptability of the people actively participating. Investment in research and applied sciences is the key igniter of progress for those communities that want to lead in today’s world.
Knowledge Concepts
CEPT
A knowledge economy can be easily conceived as an environment in which different institutions, organizations and individuals use, create and share knowledge to foster sustainable technological, social and economic development of their communities.
CON
A new global community is now connected 24/7 and sharing information across borders. The creation of wealth by communities worldwide is closely tied to their ability to become part of this new comprehension of human development and economic growth. Investment is key in areas such as education, health and telecom provide the groundwork for an effective incursion into the highly productive and profitable knowledge paradigm.
ACCESS
Access to knowledge must be seamless; databases, digital libraries and networks must be available to everyone.
AP
ON
TI A E
LIC
AT IO
N
CR
Conceptualizing knowledge through education and investigation.
Creation of Knowledge Letting the creation of knowledge yield intellectual property, innovation of processes and entrepreneurs.
Knowledge Applications Developing applications for all kinds of knowledge.
Delivery of services Knowledge creates a competitive advantage in the commercialization of products and services.
An economy that fosters sustainable social, technological and economic development 12
* National Knowledge Commission. Government of India
13
WHAT IS A KNOWLEDGE CITY? Knowledge cities are environments that attract highly creative and productive companies and human capital. They possess economies driven by high-value added products and services created through research, technology and brainpower. Public and private sectors come together to nurture knowledge creation and support learning and innovation, harnessing knowledge to create wealth. One of the most important factors in the transition towards a knowledge economy is having the appropriate spaces for business, government, academia and society to interact and form a fully functional system of collaboration. These pieces come together in what are known as knowledge cities: urban centers where people can live, study, work, create, share and transform knowledge. These cities are created in order to consolidate scientific and technological innovation and catalyze a country or region’s economic development. Knowledge-based communities require education, infrastructure and private sector initiatives to be aligned, creating clusters that accelerate technological and research breakthroughs. They act as magnets of talent and drive economic growth and progress, representing an exciting business opportunity where new partnerships can be explored and developed.
Key Components Knowledge cities are intrinsically intertwined with their surroundings. Their configuration, growth and success are dependent on how well they integrate with the surrounding communities. Knowledge cities have five defining characteristics that collectively determine value creation.
Key Characteristics2
Knowledge Cities
High connectivity and efficient transportation systems Energy-saving systems and water treatment plants Mixed-use complexes Pedestrian zones, walkable distances and integral city planning Talented and highly skilled human capital Horizontal structure linking different stakeholders Promotion of leadership among peers
2
14
Manage and nurture research and innovation
3
Infrastructure optimization
4
Preservation and nurturing of the natural environment
54
Key geographic location in relation to nearby cities
HUMAN RESOURCES
Creative and innovative key individuals Multidisciplinary teams
Political: government support Incentives: promote investment Security: guarantee safety and investment stability
ECOSYSTEM
Diversity of population and disciplines Cultural spaces and activities
High speed fiber optic internet access 24/7 connectivity and support City’s own productivity platform, shared by all its users
1 2
BASIC INFRAESTRUCTURE
ICT
Online education and entertainment
Public and private sector participation
National Knowledge Commission. Government of India.
A city that harnesses knowledge to create wealth 15
KNOWLEDGE ECONOMIES AND CITIES: CONCEPT DEFINITION Knowledge Economy
Gujarat Knowledge and Health advantage
Natural Elements
Mixed Use
Various Residencial Spaces
Vehicle-free Zones
Knowledge is the new basis for development in our era; it is the tool that allows to generate wealth and prosperity. It facilitates technological, social and economic development with the aim to substantially improve quality of life. Investing in research, education, and innovation is crucial to succeed in this new era.
Ecological Facilities Transportation Architecture and Urban Icons
Parking Lots and Meters
Amenities
Knowledge Cities Green Areas
Public Spaces
Knowledge Cities are highly valuable urban developments that offer an optimal quality of life thanks to its efficient and sustainable policies that promote mixed-use residential, office, research and commercial space. The mixed-use approach improves overall efficiency and generates a dynamic social cohesion and improves socioeconomic distribution of wealth and capital. High quality human resources, specialized R&D activities, private venture, local government and civil society come together to participate in communal development.
16
17
THE HEALTH CITY CONCEPT Health cities are mixed-use spaces that facilitate collaboration between diverse agents in the health care sector, helping create more impact and development, focusing its human capital and resources towards specialized health care. Main objetives of a health city
1 Attract talented professionals, pharmaceutical laboratories,
hospitals, and educational institutions to promote innovation.
Knowledge Cities
Collaboration with Government Entities Health cities function in a form of multiple decentralized entities such as clinics, research centers, hospital, and laboratories working alongside private and public sector initiatives to significantly improve health within the region. The aim is to synergize these crucial elements, address local health care concerns and involve the community at large in local activities.
2 Create patents and promote innovation for the purpose of public health improvement.
3 Increase awareness of health and environmental issues in urban development efforts.
4 Provide high quality healthcare services within the region they are developed.
5 Generate interaction areas, creating community in the city. Health cities gather a mix of different players within several spaces like the one that follows:
Social
Civil society
Residential
Businesman
Workspaces
Entrepreneurs
Hospitals
Profesors
Cultural areas
Reserches
Relational areas
Scientists
Clinical laboratories
1 Based on a commitment to scientific and technical
th ow gr
The Health City’s approach towards development consist of the following characteristics:
treatment and spe edical ciali m f zati o s a on elopment of new v e e d r d n A a p r h o c duc ear l techniques, m a ts a s c i d e e edic r m nd f w ine s o of ne se n o o f i t s r p a a e e r cializ c o n rv r t s d o f r ed a s p e e t a j c ob te s mo Spa ers of medical touri t o sm m Pro a d d r n i v a i n t g fo len rce f ta o r for to An att ra c
Medical specialist
Inc ub Pr o
AREAS
s ice s nt
PLAYERS
innovation to address public and private health issues.
2 Stimulate political decision-making to support health related issues.
18
3 Generate intersectoral action between the various entities in the city.
Health cities serve as: 19
HEALTH CITIES IN THE WORLD
Knowledge Cities
Dubai Healthcare City (DHCC)4 Cleveland Clinic, Sowwah Island Abu Dhabi2 OPENING: LOT AREA: NUMBER OF BEDS: SERVICES: INITIAL INVESTMENT: DEPARTMENTS: INSTITUTES:
2013 9.4 Ha 360 (expandible to 490) tertiary/quaternary in neurological, respiratory, digestive and heart. 1.4 billion dollars 2 departments (Medical Subspecialties and Surgical Subspecialties) 5 institutes (Digestive Disease, Heart & Vascular, Eye, Neurological and Respiratory)
OPENING: LOT AREA: NUMBER OF BEDS: SERVICES:
INITIAL INVESTMENT: EMPLOYEES: PATIENTS ATTENDED:
2002 38.1 Ha 1,000. Over 90 medical facilities specialized in pediatrics, gynecology, oncology, cardiology, diabetes, cosmetic surgeries, ophthalmology and orthopedics. AED 11 billion earmarked for investment in Phase I and II. 2,500 healthcare professionals. (year) 2000 patient.
Texas Medical Center 3 OPENING: LOT AREA: NUMBER OF BEDS: SERVICES: ECONOMIC IMPACT IN THE ZONE PATIENTS ATTENDED:
EMPLOYMENT: STUDENTS: RESIDENTS AND FELLOWS: VISITS:
20
1936 M.D. Anderson Foundation 526.1 Ha 6,900 From primary to quaternary care. 32 billion (year) 7.1 million (International patients 16,000) One of the worlds largest medical agglomerations in the world. (50 non profit and public institutions ) 92,500 34,000 4,000 Scientists, researchers and students: 7,000
Mount Elizabeth Novena Hospital -Singapore5 OPENING: LOT AREA: NUMBER OF BEDS: SERVICES: INITIAL INVESTMENT:
2012 73 Ha 333 (More than 250 physician suites) Heart and vascular, neurosciences, orthopedics, oncology,and general surgery. 2 billion dollars
3
Cleveland Clinic, 2012
5
Dubai Healthcare City, 2012.
4
Texas Medical Center, 2012.
6
ParkwayHealth Hospital, 2012
21
India represents one of the world’s most rapidly growing economies
INDIA AND GUJARAT AT A GLANCE
Gujarat Knowledge and Health advantage
India
Gujarat
India represents one of the world’s most rapidly growing economies. The country covers 2.4% of the world’s land area and supports over 17.5% of the world’s population. It has the 2nd highest population in the world and economic growth rates are projected at 7% for 2012.7
Gujarat, a Western Indian state, was ranked as the best state for local investment by Stock Marketing India, receiving 13.2% of investments coming from within India. The state has become increasingly well positioned over the last decade due to its rapid industrial and service sector growth. The state is home to the world’s largest oil refinery as well as strong textile, petrochemical, precious stone and processed food industries.
The sectors of highest growth in 2011 were as follows:
real estate market
petroleum derived exports
DELHI
basic services (water, gas and electricity)
472 miles
1hr. 10 mins.
India’s Economy 20118 1 GDP (Gross Domestic Product)
total $ 1.7 trillion USD
2
62.34% of GDP
Public Debt
3 Population size
1.2 billion
4 Labor force
487.6 million
5 %BPL (Below Poverty Line)
37%
6 Urban/Rural population
27.8 / 72.2
per capita $ 3,703 USD
AHMEDABAD
8 Exports
$ 300 billion USD
9 Main Export goods
Petro products, precious stones, machinery, iron, steel, chemicals, vehicles, apparel
US 12.6% UAE 12.2% China 8.1% Hong Kong 4.1%
11 Imports
$485 billion USD
12 Import goods
Crude oil, precious stones, machinery, fertilizer, iron, steel, chemicals
• Cement • Telecommunications • Transportation • Machinery • Software • Pharmaceuticals
Services • IT • Software • Business Process Outsourcing • Pharmaceuticals • Machinery
CHENNAI 859 miles
1hr. 55 mins.
India’s main states economic figures 9
Industry • Mining • Textiles • Chemicals • Food processing • Steel • Petroleum
1hr. 35 mins.
46 mins.
10 Main exports partners
• Potatoes • Cattle • Water Buffalo • Sheep • Goats • Poultry • Fish
750 miles
309 miles
$ 19.42 billion USD
• Rice • Wheat • Oilseed • Cotton • Jute • Tea • Sugarcane
HYDERABAD
MUMBAI
7 FDI Inflow (Foreign Direct Investment)
Agriculture
India is quickly becoming a global symbol of prosperity
26.3%
18.1%
56.6%
Gujarat
Maharashtra
Uttar Pradesh
Andhra Pradesh
Tamil Nadu
$ 90.650 billion USD
$ 190.310 billion USD
$ 109.770 billion USD
$ 100.350 billion USD
$ 97.970 billion USD
1
GDP total
2
GDP per capita
$ 1350 USD
$ 1568 USD
$ 488 USD
$ 1,077 USD
$ 1,350 USD
3
Population size
60.3 million
112.4 million
199.6 million
84.7 million
72.1 million
4
Urban/Rural population
31% / 69%
36% / 64%
22% / 78%
42% / 58%
38% / 62%
5
FDI Inflow
$ 2.43 billion
$ 1.85 billion
6
Main sectors
7
Main city
$ 230 million Oil, textile, petrochemical, precious stones,processed foods
Ahmedabad
Agriculture, machinery, textiles, petroleum
Mumbai
$ 316 million
Agriculture, manufacturing, IT
Delhi
Hyderabad 9
24
7
CIA. (2012). The World Factbook, 2012.
8
International Monetary Fund/ World Economic Outlook Database, 2012.
Agriculture, services, minerals
Agriculture, textiles, automobiles, heavy industry
Chennai
Rediff Business. (2011). India’s Top 20 states by GDP, 2012.
25
HEALTHCARE IN INDIA
Gujarat Knowledge and Health advantage
The Indian healthcare market is poised to become the world’s first mass market for healthcare consumption
The Indian healthcare market has seen a significant grow in the last years, due mainly to an increase on the investments by private and public sectors, and to the rising income levels within India.
It accounted for 5.1% of the national GDP in 2008 and is expected to generate 9 million new employments by the end of 2012.10 National 1995
2009
% change
1995
2009
% change
Per capita expenditure on health
$ 16.48
$ 54 USD
+ 71%
$ 456.95
$ 863.58 USD
+ 47%
Under 5- Mortality Rate (Per 1,000 live births)
99.5
65
- 35%
83.47
59.23
- 29%
Life Expectancy
59.83
66
+ 8%
66.18
69.41
+ 5%
USD
Hospital bed density and numbers of medical professionals continue to rise, but with such a rapidly growing consumer market, medical infrastructure and education will need to be heavily invested in and strongly bolstered to be able to meet such quickly growing demand.
World Average
USD
PRIMARY General healthcare, usually preventative, within primary and community health centers. SECONDARY Involves hospital and acute care, which involves more specialized technicians and professional attention.
Indian Market Share11
Hospital and bed density11
TERTIARY Most specialized form of care, usually for inpatients that require advanced techniques, surgery, and care from a specialized physician.
(Hospital beds per 1000 people)
$38 billion USD in 2008 12
Medical Physicians, Nurses, per 1,000 people13 1990
Nurses
Total Growth (1990 - 2010)
INDIA
0.44
0.6
1.3
+ 36%
BRAZIL
1.08
1.67
6.5
+ 55%
CHINA
1.55
1.43
1.3
- 8%
WORLD
1.21
1.4
2.9
+ 16%
10
26
Doctors
2010
World Bank, Health Indicators, 2009.
• Rising income levels and health insurance coverage (currently 30% insurance patients have created a growing demand for tertiary care, which currently has 11% of the market share). • 100% FDI allow in hospital sector, US$379 millions in 200714 • Private sector investments in India increased 227% between 2002 and 2008.
Indian Pharmaceutical Sector
50
Grows
billion USD
worth expected to be, by 202016
largest in terms of volume due to production capacity and low labor costs15
around 1.5 times country’s GDP growth15
Biggest went from $8.7 billion USD in 2008 to $10.4 billion USD in 201013 13
pharmaceutical product is generic drugs, producing over 20% of the world’s generics16
iNDEXTb, Healthcare Sector Profile, 2011.
11
WHO, World Health Statistics, 2011.
14
12
Cehat, Review of HealthCareIndia, 2001.
15
Corporate Catalyst India, 2012.
16
PWC , Global Pharma looks to India, 2010.
Shah et Mohanty, 2010.
27
HEALTHCARE IN GUJARAT
Gujarat Knowledge and Health advantage
Health and infrastructure indicators18 The Gujarat Government will be injecting upwards $3 billion USD into the public healthcare sector by 2020. Currently, 81% of the state’s Allopathic (conventional medicine) clinics are located in rural areas with 19% in urban areas but Gujarat’s rapid rates of urbanization will place increasing demand on urban hospitals. Rising income levels and health insurance coverage are creating a growing demand for the state’s tertiary care sector, which currently has 4% of the market share (Currently almost 70% of otimary healthcare is invested by the private sector).
Per Capita Healthcare Expenditure 2001
11%
$18.29
17%
$22.00
+26.7%
Primary
$30.00
% 79
India Avg.
Market Share17
2005 +14.4%
Gujarat
2009
48
50
2016-2020
72.2
69.6
Primary Health Centers (per 100,000 population)
2009
1.82
1.94
Community Health Centers (per 100,000 pop)
2009
0.47
0.37
Sub-Centers (per 100,000 population)
2009
12.23
12.08
Avg. number of villages served by Primary Health Centers
2009
17
25
Number of physicians (per 100,000 population)
2007
71.2
57.7
Life expectancy
11% $15.66
Year
Infant Mortality Rate (per 1,000 population)
4%
Gujarat
Item
India
Secondary Tertiary
$29.38
-12.6%
$26.09
nd ia
I
Punjab
Gu
In
Uttar Pradesh
$29.38
-15.4%
$26.09
Rajasthan
$11.46
+21.5%
$14.59
dia
jara t
Comparative Bed and Hospital Density - 2008 (public only)19 Hospital density
(number of beds per hospital)
Bed density
(number of beds per 1000 inhabitansts)
78 %
Gujarat National Avg.
77.6
0.5
43.8
0.43
46
0.4
35
0.22
67.5
0.51
Public spending Private spending Private/Public unavailable
Gujarat’s prosperous population is placing a growing demand on the state’s healthcare infrastructure 17
28
iNDEXTb, Healthcare Sector Profile, 2011.
Punjab Uttar Pradesh Rajasthan
CBHI, Health Infraestructure, 2010.
18 19
Directorate of Economic and Statistics of Gujarat, 2008.
29
GUJARAT’S HEALTHCARE ECOSYSTEM
Gujarat Knowledge and Health advantage
Prices Comparison Gujarat, with nearly 9,000 health clinics all around the state, a specialized network of hospitals, universities and a multitude of skilled knowledge workers make possible the development of a health city and solidify it’s position of innovative leadership in India.20
Drug prices of most medications are consistently lower in India than in developed countries. This represents a huge opportunity for increasing exports.
Price comparative in USD Nominal GDP (Per capita)
Modern vs. Traditional Medicine21 Modern Indian medical practices mix fluidly with traditional medicine depending on religion, education, socio-economic background and region.
Preferred by urban populations (1/3 of rural population uses primary healthcare)
Preferred by rural populations (2/3 of rural population uses for primary healthcare)
Preferred by 79% in emergencies or to treat life-threaening diseases
Preferred by 65% for treatment of common aliments and non-life threatening situations
Almost four times the cost of traditional medicine
Less costly for both provider as well as patient
Newer and more popular in wealthier, urban population
Deeply engrained in the collective psyche due to thousands of years of effective use
• Employment in Gujarat’s pharmaceutical industry almost doubled between 1980 and 1990.
• 3,500 drug manufacturing units.
CAGR
(Compound Annual Growth Rate)
Pharmaceutical Sector
GUJARAT
$50,436 USD
Medication
Use
India
USA
Canada
Ciprofloxacin
Antibiotic
0.45
32.31
10.12
Ibuprofen
Pain killer
0.12
0.17
0.52
Insulin
Hormone
15.88
9.48
27.78
Omeoprazole
Gastro disease
0.31
8.51
15.42
Main Pharmaceutical companies During the last decade, Gujarat’s pharmaceutical companies have been expanding their global footprint, working towards getting their facilities approved by international regulatory bodies. Gujarat’s main pharmaceutical companies include:
Active pharmaceutical ingredients (APIs) (mainly in India and the U.S)
Zydus Cadila
INDIA 5th largest pharmaceutical company in the world; generic drugs.
Total Value
$.7 billion USD
$4.4 billion USD
88%
18%
Exports Value
$.2 billion USD
$1.1 billion USD
78%
28%
Gujarat’s healthcare ecosystem is rich and diverse in history as well as pharmaceutical output 20
Commissionerate of Health, Medical Services, Medical Education and Research of Gujarat State, 2010-11.
21
Gordon, Sonia. Bernadett, Martha. Evans, Dennis. et al. Asian Indian Culture: Influences and Implications for Health Care. April 24th, 2012.
22
$48,387 USD
Sun Pharma
Pharmaceutical sector22
30
$1,389 USD
KPMG. (2008). Gujarat Pharma Industry.
Torrent formulations, APIs and drug discovery.
Dishman one of the world’s largest API and chemical manufacturers; research and manufacturing of bulk drugs and chemicals 31
GUJARAT’S HEALTHCARE ECOSYSTEM
Gujarat Knowledge and Health advantage
Some of the state’s most important medical colleges are: Health education in Gujarat is strong on a national scale but will continue to grow rapidly as more medical professionals are absorbed into the labor market. Medical research continues to grow as Indian pharmaceutical companies grow and international players outsource their R&D departments to India.
B.J Medical College, Ahmedabad24 •One of the largest sources of medically qualified manpower in India • 250 students per year; master degree courses in 15 branches of medicine • Recognized by the World Health Organization for innovation in integrated teaching and training programs in child health services and universal immunization • Medical graduates span the world, practicing mainly in the U.S. and UK
Healthcare Education and Research23 The surge in technology in the healthcare sector has brought highly specialized training and advanced programs for schools in Gujarat. Research clinics are abundant and concentrated in urban areas. With almost 83% of total education infrastructure in Gujart, Private Healthcare Institutions in research and education have an important influence over the region. Public-Private Partnerships are also playing an extraordinary role in healthcare. Several disciplines of medicine are prevalent within the region:
Government Medical College, Surat25 • 150 students for Bachelor of Medicine degree per year • Works in conjunction with the New Civil Hospital, which admits 75-80 patients daily • 2000 outpatients attended daily
No. of Government Institutions
No. of Private Institutions
Total
Total Students Admitted
6
8
14
1,357
n/a
12
16
1,300
Ayurvedic
4
n/a
6
375
Dental
2
9
11
280
Physiotherapy
3
19
22
220
2.4
42
66
n/a
Pharmacy
3
97
109
825
Total
42
187
244
4,375
Discipline Allopathic Homeopatic
Nursing
M.P Shah Medical College, Jamnagar26 • 200 students a year • Specializes in general medicine, radiology, TB and respiratory diseases, obstetrics, ophthalmology, general surgery and orthopedics
Key Research Institutes Institute of Kidney Disease and Research Centre (IKDRC)27
Research initiatives Because of the high rates of coronary and lung disease as well as diabetes, mental illness and infant mortality, the main focus of healthcare provision as well as research initiatives are focused on the following topics:
Cardiology 32
23 24 25
Stem cell research
Nephrology
Oncology
Commissionerate of Health, Medical Services, Medical Education and Research of Gujarat State. Health Statistics Gujarat 2010-11.
IndExtB. (2011). Healthcare sector profile. Government Medical College, Surat, 2012.
• Largest tertiary care center of its kind in the world • 400 indoor beds for nephrology, urology and transplantation • Pioneered stem cell therapy to treat nephritis in 2009 • Research has led to education of immunosuppressant medications for kidney transplant patients Embryology
Gujarat Cancer Research Institute (GCRI)28
Surat Municipal Institute of Medical Education & Research29 • 150 students admitted every year • Self-financied by the Surat Municipal Corporation • All faculty and post-graduate students participate in research activities. Published research ranges from malaria to muscular fitness to hypothyroidism
• 650 indoor beds, making it the largest cancer hospital in the country • Over 11 million laboratory tests • Research in cell biology division, molecular endocrinology, biochemistry, receptor and growth factors, immunohistochemistry and pharmacogenomics 26
MP Shah Medical College, Jamnagar, 2012.
27
Institute of Kidney Disease and Research Centre, 2012.
28
Gujarat Cancer & Research Institute. Annual Report, 2012.
29
Surat Municipal Institute of Medical Education & Research, 2012.
33
GUJARAT: MAIN CAUSES OF DEATH AND MOST COMMON DISEASES Although Gujarat has gone through major improvements in nutritional and health infrastructure, social development and the eradication of major diseases over the last decades, general healthcare, prevention and lifestyle ailments need to be strengthened.
Gujarat Knowledge and Health advantage
Gujarat’s leading causes of death are becoming increasingly healthcare related
39.2% Pulmonary Circulation 31.4% Ischemic Heart
Leading Causes of Death in Gujarat as od 201030
Account for over 16% of deaths in Gujarat including:
51.7% Bacterial septicemia 23.3% Tuberculosis 3.9% Malaria 3.8% HIV Gujarat has one of the highest risks of malaria in India
Disease
18.6%
Circulatory Disease
14.7%
4.3% Other
die yearly of heart attack
4.7%
14.01%
Nutritional and Digestive System Disease 23%
Other causes
of men
10.6%
Injury, poisoning orother external cause
23.3%
Symptoms, signs & Abnormal Clinical & Laboratory Finding NEC
Top Five Causes of Death in India31
14.9%
Hypertension
5.4% and Hypertensive Heart Disease
56,000 people
Infection and Parasitic Disease
7.1%
18.8%
Vascular 19.5% Cerebro Disease
Cardiovascular
Respiratory
Respiratory Disease
5.9%
Conditions originating in perinatal period
52%
72%
of women of infants
are anemic
National Family and Health Survey
Nutritional and Digestive System Diseases • Liver disease 72.6% of digestive disease, pancreatic disease (3.9%), peritonitis (4.6%) and intestinal disease (5.2%). • India is poised to become the diabetes capital of the world by 2025. (62 million Indian adults currently) • 22% of the 70,000 patients tested were diabetic (Ahmedabad).
8.1% Diarrheal 6.2% Perinatal 6% Tuberculosis 34
Health and Family wealthfare department , Medical Cerfication of Cause of Death, 2010.
30
Indian Council of Medical Research (ICMR) 2010.
31
35
GUJARAT: MEDICAL TOURISM32
Gujarat Knowledge and Health advantage
Most common procedures and cost comparison More than 450,000 patients visit India annually from abroad to take advantage of reduced medical costs as procedures can cost up to 1/10 compared to the U.S. The medical tourism Industry in India currently generates $2.2 billion USD growing at an annual rate of 30%.
Cost in the US
• Important motor of Gujarat’s recent surge within the healthcare industry. • Over 30% of Indians living abroad are Gujarati. The influx of Non Resident Gujaratu (NRG) medical tourism has made Gujarat better known as a medical tourism destination • Estimates place Gujarat capturing 10% of India’s medical tourism.
Medical tourism
grew
by 33% in 2009
Tendencies • India’s booming economy is attracting NRG and skilled-doctor Indians to return from abroad. (100,000 Indians returned during 2010) • Indias medical tourism share globally could reach around 3% by 2013 (RNCOS) • Ahmedabad is closing the gap as one of the preferred medical tourism destinations in India, now matching services available to those in Delhi and Mumbai. • Apollo Hospitals, is the main Indian chain with 53 hospitals and over 8,500 beds.
69,350
230,650
Heart Surgery
30,000
8,700
21,300
Orthopedic Surgery
20,000
6,300
13,700
Metal Free Bridge
5,500
600
4,900
Dental Implants
3,500
900
2,600
Porcelain Metal Crown
1,000
100
900
Tooth Impactions
2,000
125
1,875
Root Canal Treatment
1,000
110
890
Tooth Whitening
800
125
675
Tooth Colored Composite
500
30
470
Tooth Filling
300
90
210
The most popular medical tourism procedures in Gujarat are:
1
Hip and joint replacement
2
Cardiac operations
3
Plastic surgery
4
Breast augmentation
5
In-vitro fertilization
6
Kidney disease treatment
Tourist Countries of Origin • Mainly non-residents or foreigners from the U.S., UK, former Soviet Union, Uganda, Nigeria Africa and the Middle East . • Advantages for medical tourists: – No wait times (VS 6-18 months waiting times in their home countries) – World-class health facilities – Reduced costs – Availability of latest medical technologies – Growing compliance on international quality standards, – No language barrier for English-speaking patients.
Medical tourism is a burgeoning industry in Gujarat’s economy IndExtB. “Healthcare sector profile”, 2012.
32
36
Deloitte, 2008./ “Medical Tourism”, 2012.
31
Difference
300,000
Liver Transplant
Growth of medical tourism in Gujarat
Cost in Gujarat
Medical tourism growth33
2002
150,000 patients 2007
450,000 patients
37
HEALTH CARE MARKET: PRELIMINARY CONCLUSIONS AND BUSINESS OPPORTUNITIES
Gujarat Knowledge and Health advantage
Opportunities38 Gujarat is strategically located to give easy access to both national and international markets. Excellent road, rail, maritime and air networks have allowed for rapid development and created one of India’s leading investment destinations.
INDIA34
HEALTHCARE
IT
GUJARAT35
Health Care industry estimated to reach $77 billion USD by 2013
Quickly evolving healthcare intrastructure in terms of hostipals, healthcare centers and beds and is expected keep growing
Expected to generate 9 million new employments by 2012
Requirement for more tertiary care and basic healthcare provision
3rd largest pharmaceutical sector in the world in terms of volume
13 medical college, 1,072 Primary Health Care (PHC); 7,274 sub centres, 273 Community Health Centres (CHC) and 85 mobile healthcare units
Hospital Investment 100% Income Tax Exemption for new hospital over 100 bed (Finance Act, 2008)
131 MOUS worth $5.04 billion USD were signed in 2011 by national and international health-care companies during Vibrant Gujarat (60% healthcare sector and 40% in pharmaceutical)
INTEGRATED
MEDICITY MEDICAL
TOURISM
Concentration of Healthcare Assets37 The western region of Gujarat shows heavy concentration of medical R&D institutions, hospitals and educational institutions. Developing areas where these three components can easily and efficiently work together through multi-disciplinary healthcare clusters could leverage Gujarat’s position as a leading healthcare provider in India.
Market has grown over
200%
in the last decade
HEALTH CLUSTERS
THAT BRING
TOGETHER:
Management of health information across computerized systems Increasingly viewed as the most promising tool for healthcare delivery and quality
• Health education • Hospitals • Clinics • Research institutions • Pharmaceutical companies to leverage their collective expertise createprofitable synergies
2.2
billion USD in revenues
GROWING GENERIC DRUG DEVELOPMENT ANNUAL RATE
+7.8%
R & D Institutions
30% estimated
growing rates
state to become a key tourism destination
Drugs coming off patent globally by 2014 represent
136
billion USD
Medical Colleges MBBS and dental
With $3 billion USD in public funding in healthcare by 2020 and a Compound Annual Growth Rate of 58.34% in Gujarat’s pharmaceutical sector alone, Gujarat is well-positioned to become a global healthcare powerhouse
Hospitals HEALTH CARE CLUSTERS PROPOSED POLYGONS SEZ
Airport
Funcional
International Domestic
Notified and Operational
SIR
Railway
Operating Proposed
Ports Major Port
38
39
IndExtB. Healthcare sector profile, 2012.
34
Government of Gujarat. Socio Economic Review 2010-11.
35 36
Gujarat Industrial Development Corporation. Special Investment Regions of Gujarat and CIDC, 2012.
37
Report Linker. (2011). Generic Drug Industry: Market Research, Reports, Statistics and Analysis, 2012./Deloitte,2008. Medical Tourism, 2012.
60km
The site’s strategic location near Ahmedabad creates a wealth of possibilities for the sustained, longterm success of the Health City
LAND LOCATION
Health City Proposal: Conceptual Overview
The site is well-connected to important cities globally as well as regionally
The site is conveniently located six hours by plane from several important urban areas throughout Asia, and twelve hours from major urban capitals such as Tokyo and London.
LONDON 4,588 miles
11 h 55 mins.
TOKYO 4,139 miles
KUWAIT
11 h 35 mins.
1,685 miles
5h 50 mins.
DOHA 1,334 miles
3 h 15 mins.
DUBAI
AHMEDABAD
1,097 miles
2 h 45 mins.
Ahmedabad is a 12-hour ight from London or Tokyo and under 6 hours from important regional cities such as Singapore 42
SINGAPORE 2,581 miles
5 h 30 mins.
43
LAND LOCATION
Health City Proposal: Conceptual Overview
DELHI
469 miles
1h 20 mins. 578.5 miles
12h 41 mins. 15h 40 mins.
Thanks to its centric location in Gujarat, the Health City will provide state-of the art facilities on specilaized treatments for the region, and other important cities within India
GUJARAT The site is conveniently located at 53 miles from Ahmedabad Airport
GANDHINAGAR 16.78 miles 0 h 43 mins. 0 h 38 mins.
AHMEDABAD RAJKOT
142.29 miles 4 h 12 mins. 3 h 46 mins.
VODADORA 70.84 miles 1 h 40 mins. 2 h 05 mins.
BHAVNAGAR 107.5 miles 5 h 45 mins. 3 h 12 mins.
SURAT
164.66 miles 3 h 45 mins. 4 h 09 mins.
Gyan Gram Health City SURENDRANAGAR 27.2 miles
AHMEDABAD 49.5 miles 53.31 miles
to train station to airport
to train station
MUMBAI 275 miles
1h
327.46 miles
8h 7 mins. 7h 55 mins.
Plot to northern highway number 7: 2.77 miles Plot to southern highwaynumber 17: 3.75 miles
44
45
CONTEXTUAL STUDY: THE LAND AND ITS SURROUNDINGS
URBAN FABRIC
Health City Proposal: Conceptual Overview
The urban fabric is designed taking into consideration two important aspects. Identifying and adopting elements of the Indian urban fabric is essential to preserve integrity of local communities and the design of their spaces and buildings. The Health city aims to preserve such organic aspects of Indian urban concentrations. Second, urban planning is important to imagine improvements in quality of life for future generations of inhabitants. The mix of the organic Indian city and the planned scheme will be part of the design for the Health City.
It is of vital importance to consider the natural context in which the new city is situated when designing a project proposal. In identifying basic data regarding temperatures, rainfall or wind, we can underline certain characteristics that will make the city easier to live in. Aside from the natural setting, by situating the connections and boundaries of the future city, we will be able to establish a strategy to improve the efficiency of the functionality and future growth of the urban development. The site in question is located approximately 75km to the west of Ahemedabad. It is accessible through highway 7 after about 2 hours of commuting. The location of the site, so close to Ahmedabad and Ghandinagar puts it in a strategic position for its future development.
N
Low Vegetation
1
2
High Vegetation
Flooding zone
3
SW
Water
SECTION
A Town
B
4
C
Area 790 ha 0
Water channel
Low Vegetation
1
46
High Vegetation
Flooding zone
Water
2
Town
Water Channel
100
Area 790ha
1000m
500
Prevailing winds
3
4
The health City urban fabric design preserves essential Indian elements combined with strategic urban planning to guarantee life quality of its inhabitants 47
PROGRAM COMPONENTS
Health City Proposal: Conceptual Overview
The Health City Master Plan is configured as a high-density and mixed-use development that will allow a dynamic pedestrian life and a strong sense of community, as inhabitants will experience the sensation of a town within a city with the ability to meet their daily needs in very short distances.
Light Industry Ammenities Basic Services
Construction Footprint
Education
6%
6%
5%
Residential
39%
2%
24% 88 ha
Commerce City Block Centers Footprint
15% 58 ha
Green Areas Footprint
13% 51 ha
Green Ring Footprint
13% The master plan is designed 51 ha
Infraestructure
12%
Health
17% Office
to maximize the potential of the healthcare components 35% 132 ha of the development
12% Health Care Offices Research centers
The medical components of the health city will serve to meet Gujarat’s growing demand for a more robust health infrastructure in specefic specialties where the region can be benefited such as Cardiology, Nutrition, and others. As well they will foster innovation and new product creation within the healthcare sector and help bolster the region’s economy. Nearly 40% of the construction footprint will be allotted to residential areas. This will allow people working in the health city to live there as well, cutting out long commute times and creating an integral sense of community rather than a transitory one. The Health city mix-use design will create a solid internal market, creating quality jobs for people at the Health, Education and Office areas, while creating synergies and an economic diversity and providing the necessary elements to become a destination itself. 48
Construction Footprint
6%
11%
Hospitals
Health
49%
Pharmaceutical
26% Wellness Center
8%
49
Link with Bodies of Water Vegetation Coverings
There will be a pier and topographical treatments that will minimize the impact of rising levels of water in specific areas during monsoon season.
Vegetation will be used to cover building faรงades throughout the entire development giving added thermic comfort to inhabitants.
Peripheral Rings The streets with the highest capacity for traffic are located on the periphery of the development so as not to affect internal movement and transportation.
HEALTHCARE FACILITIES
Health City Proposal: Conceptual Overview
The Health Village will consist of world-class facilities including hospitals, offices, residential, research centers, educational, to attract both domestic and international health users and entities to Gujarat.
1
Research centers and laboratory
Individual lab suites equipped with state-of-theart medical tools and technology. They will support scientific and health oriented researchers, companies and organizations and foster the exchange of research and technology skills among the city.
2
Pharmaceutical labs
India has become the world’s leading manufacturer of generic drugs possessing about 80% of the global market share. Pharmaceutical companies globally have been shipping their R&D departments overseas due to the advantageous low costs in manufacturing. World-class space for pharmaceutical companies will be available, to leverage its proximity to other research and medical entities, and continue producing cutting-edge medicinal drugs at low cost.
3
Wellness center
The Wellness Center will adopt traditional Indian practices in order to provide pro-active and preventative medical treatment options to patients. Aspects of ayurvedic, unani and homeopathic treatments will be made available, also aiding in therapeutic and rehabilitative treatments.
4
Idea Lab
A light industry R&D lab dedicated to making healthcare smarter through related IT initiatives and the development of innovative services, tools and products that create different methods for healthcare provision. Research on tele-medicine, smart hospital management and treatment tracking systems, ‘big-data’ collection and implementation systems, rural medicine tools would be carried out in the lab.
Strategically designed facilities to propel research and devolpment for the healthcare industry 52
53
Public Ammenities Throughout the development there are different spaces designated for public amenities, categorized by size or use. There are pedestrian walkways that link commercial areas and activity with green spaces.
Parking Public parking lots will be located on secondary streets where the flow of traffic is less heavy.
Transportation Path Crossings Throughout the development there will be vehicular intersections and pedestrian crossings resolved through the use of multi-level construction to limit transportation interruptions.
COMMERCE AND OFFICE FACILITIES
Health City Proposal: Conceptual Overview
Commerce Facilities
Office Space Street Level Commercial Areas
1
The city plans to incorporate one university with a strong focus on medicine and diverse health studies and a nursery school. Students finishing collegiate and graduate studies will provide a highly skilled labor force for the city and its surroundings.
Commercial Corridor
2
Located in central area of the master plan from north to south allowing a pedestrian corridor and connecting the central buildings of the development. This space seeks to create a link between population and public space.
Wholesale Food Market
1
Office Space Class A
Class ‘A’ office space are outfitted to ensure top quality services, complete with sleek design, state-of-the-art facilities, modern furniture and excellent accessibility. These offices can be customized to the needs of physicians, pharmaceutical entities, financial services entities, entrepreneurial offices, and government institution. Offices throughout the city will encourage commerce to grow in various zones within the Health City.
2
Collaborative Spaces
Offices in the Health City emphasize the development of collaborative spaces to encourage interaction between office employees, neighbors, opposing ventures, etc. The aim is to create new relationships and harness the power of innovation among a diverse set of skilled professionals to promote entrepreneurship. Furthermore this space enables innovation and business growth.
3
The wholesale food market would serve as a major distribution point for markets, restaurants, hospitals, and other institutions that depend on easy access to food supply for business activity and daily life for the habitants.
Professional activity areas that maximize the potentail for collaboration 56
57
High-Density Zones The development’s tallest buildings are concentrated in the central part of the development. Bodies of Water Reflection pools or bodies of water in constant movement and located to maximize the cooling effects of crossing winds help generate a better climate in public spaces and buildings within the development. They also provide recreational spaces.
Pedestrian Pathways Pedestrian pathways with no motorized vehicles allowed connect different areas of the development and cross through green areas.
EDUCATION AND RESIDENTIAL FACILITIES The Health City will attract medical educational institutions from around the world where doctors and nurses will be educated and trained in general medicine, nursing, and other specialized areas within the different village’s clinics. Health city will leverage the shortage of doctors, nurses, and qualified medical staff in Gujarat; there are only 1.3 medical colleges per 5 million inhabitants, whereas India as a whole is expected to have 1 school per 250 thousand inhabitants.
Education FacilitiesÂ
1
University and Nursery School
The city plans to incorporate one university with a strong focus on medicine and diverse health studies and a nursery school. Students finishing collegiate and graduate studies will provide a highly skilled labor force for the city and its surroundings.
2
Health City Proposal: Conceptual Overview
World-class educational and residential facilities will establish the cornerstone for all social, innovative, and entrepreneurial ventures within the Health City Residential Facilities
1
Housing
Residential Areas within the city will provide world-class living spaces and provide easy access to all activities occurring nearby. The living spaces within will adapt to a variety of needs, from those of visiting students or researchers to permanent accommodations for entire families from different social strata.
2
Hotel Accommodations
The Hotel Suites will offer non-permanent accommodation for researchers and other visitors staying within the city for short periods, providing work or study space for its guests. Access to services will be wholly integrated to the rest of the site, providing access to all of its public facilities.
Training Centers
Aimed at closing the gap between education and industry, industry-specific training centers will be allocated for members of surrounding communities so they may form part of the Health City’s labor force.
3
Elementary Education
To ensure a cohesive and comprehensive environment for permanent workers, students and researchers, the city will contain primary and secondary education facilities across the area. This will motivate its inhabitants to live and work within the city, guaranteeing access to strong education for their children. 60
61
LIGHT INDUSTRY AND BASIC SERVICE FACILITIES
Health City Proposal: Conceptual Overview
Light industry consists of crucial sectors of the economy such as light manufacture, production, and processing. The following sectors are essential components of the Gujarati economy that will play a significant role within the commerce and industry of the Health City.
1
Gems and Precious Stones38
Gujarat is the leading producer of Gems and precious stones by contributing 72% of India’s total exports. The national industry is currently valued US$30.4 billion. The sector is expected to register a compoud annual growth rate (CAGR) at 13% during 2011–13. Increased investment and supportive policy promises to allow Indian SMEs involved in the sector to reach larger distributions and more diverse markets. Within the Health City, gems and precious stones will contribute to small and medium sized stores targeting upscale to mid-range professionals permanently or temporarily residing in the Health City.
2
IT Services and E-engineering39
Gujarat is attracting several large multinationals and local companies to setup IT operations within the state. The latest information has estimated that the IT sector is worth over US$300 million in Gujarat, and has had double digit increase in growth rates in the past five years. In Guajarat the IT sector creats employment opportunities for about 200,000 person in the next 5 years. The Health city will be a hub for IT services and eengineering companies. Setting up a solid cluster for SMEs and multinational companies, will help participants tap into global markets, and create new solutions for clients worldwide. Companies will have a local market to provide their services and access to transnational clients.
BASIC SERVICES The collection system is divided into zones. The treatment system differentiates between organic and inorganic residuals, as well as bio-hazardous and industrial waste. On the periphery of the city is a Center for Energy Saving programs and a Recycling Center for of solid waste will handle sustainable waste treatment. Methane will be generated through the treatment of solid waste.
RECOLLECTION AND WASTE TREATMENT FOR SOLID RESIDUALS
The Health City will have an electricity generating plant and a solar energy park which will jointly produce 62.9 GW h (Giga watts per hour) of energy. Furthermore, all of the buildings in the health sector will have a generator that guarantees100% of their energy supply.
ENERGY SUPPLY & STREET LIGHTING
The Health City’s water supply will come from water sources within close proximity to the development and will distribute to the entire area.
WATER SUPPLY
There will be a water treatment plant to be used for water recycling implemented in different spaces throughout the city. Furthermore there will be a water storage facility that will permit the recycling of this water.
WATER TREATMENT PLANT
A fire station will be in charge of the local response to fires and other health concerns throughout the Health City.
FIRE DEPARTMENT
Automated drainage system that minimizes flooding throughout the city and surrounding sites.
A central police unit that will minimize the spread of delinquency and protect the entire community within the Health City.
SEWAGE & DRAINAGE POLICE STATION
Commerce and industry will be supported by basic services included in the development’s general infrastructure Indian Brand Equity Foundation. Gems and Jewellery, 2012.
38
62
39
Gujarat Industrial Development Corporation,2009. Review of Blueprint for Infrastructure in Gujarat (BIG 2020), 2012.
63
Buffer Zone A separation between the development’s limits and it’s immediate surroundings is creating through the use of a green belt that could include public programs.
Green Rooftops These spaces provide access for residents of the block where the rooftop is located. They can be used as recreational areas. They can also be used for energy-saving systems such as solar panels, rainwater collection, etc.
Transportation Nodes Different locations where bus stops, public transportation and non-motorized transportation, amenities and commerce are located.
PUBLIC SPACES AND AMMENITIES
Libraries
GREEN AREA AND NATURE RESERVE
1
Libraries will be located in major green spaces, yet still easily accessible from main urban concentrations.
Museum
2
Multi-level building that cares for the local collection of art and offers cultural activities, makes them available for public viewing through exhibits, and promote tourism.
Convention Center
3
A world class building in the city designed to stimulate economic growth and tourism. It will enable holding conventions, conferences, trade shows, meetings and special events.
66
1
Health City Proposal: Conceptual Overview
Green Areas
Green Areas are multipurpose areas that improve the quality of the urban environment in terms of better air quality, increased social interaction, and more spaces for recreation, creativity, and leisure. Green spaces represent 26% of the master plan.
2
Nature Reserve
The Nature reserve consists of land protected from the human development and pollution. Preserving landscapes, The main goal is to preserve landscapes that are home to various forms of important flora and fauna of the region.
3
Plazas & Manmade Lakes
An extended space provides a tranquil and spiritual oasis to surround a Hindu temple that is removed from the urban center, where citizens can assist in performing religious rituals.
67
Sense of Community and Responsibility By creating spaces that nurture interaction with amenities for public use by all inhabitants, a strong sense of community will be created and inhabitant’s will show more responsible commitment to conserving and improving these spaces.
Public Spaces There will be public spaces where green areas, recreational zones and places for interaction converge to give around-the-clock life to the development.
CHAPTER
1
CHAPTER
National Knowledge Commission. Government of India. http://www.knowledgecommission.gov.in/
7
National Knowledge Commission. Government of India. http://www.knowledgecommission.gov.in/about/ members.asp
8
Cleveland Clinic, 2012. http://www.clevelandclinicabudhabi.ae
9
1
2
3
Texas Medical Center, 2012. http://www.texasmedicalcenter.org
2
CIA. (2012). The World Factbook, 2012. https://www.cia.gov/library/publications/the-worldfactbook/geos/in.html International Monetary Fund, 2012. World Economic Outlook Database, 2012. http://www.imf.org/external/pubs/ft/weo/2012/01/ weodata/index.aspx Rediff Business. India’s Top 20 states by GDP, 2012. http://www.rediff.com/business/slide-show/slideshow-1-indias-top-20-states-by-gdp/20110722.htm
4
World Bank, Health Indicators, 2009.
10
34
Commissionerate of Health, Medical Services, Medical Education and Research of Gujarat State. Health Statistics Gujarat 2010-11. April 19th, 2012. http://www.gujhealth.gov.in/images/pdf/HEALTH_ STATISTICS_2010-11.pdf
35
KPMG. 2008. Gujarat Pharma Industry. April 2th, 2012. http://www.in.kpmg.com/pdf/gujarat-pharma08.pdf
23
IndExtB. (2011). Healthcare sector profile, 2012. http://www.vibrantgujarat.com/images/pdf/ healthcare-details.pdf
24
Government Medical College, Surat. (2012). http://gmcsurat.org/
WHO, World Health Statistics, 2011.
11
MP Shah Medical College, Jamnagar, 2012. http://mpsmc.in/
Cehat, Review of HealthCareIndia, 2001.
12
ParkwayHealth Hospital, 2012 http://mountelizabethnovena.com
6
Institute of Kidney Disease and Research Centre, 2012. http://www.ikdrc-its.org/
27
INDEXTb, Healthcare Sector Profile, 2011.
13
Shah et Mohanty, 2010.
14
IndExtB. Healthcare sector profile, 2012. http://www.vibrantgujarat.com/images/pdf/ healthcare-details.pdf Gujarat Industrial Development Corporation. Special Investment Regions of Gujarat and CIDC, 2012. http://www.gidc.gov.in/pdf/SIR-Brochure.pdf http:// www.gidc.gov.in/pdf/GIDC_Brochure.pdf
36
25
26
Dubai Healthcare City, 2012. http://www.dhcc.ae
5
Government of Gujarat. Socio Economic Review 2010-11, 2012. http://financedepartment.gujarat.gov.in/ budget11_12_pdf/34_Socio_Economic_Review_ English.pdf
22
Report Linker. (2011). Generic Drug Industry: Market Research, Reports, Statistics and Analysis, 2012. http://www.reportlinker.com/ci02261/Generic-Drug. html Deloitte,2008. Medical Tourism, 2012. http://www.deloitte.com/assets/DcomunitedStates/Local%20Assets/Documents/us_chs_ MedicalTourismStudy(3).pdf
37
Gujarat Cancer & Research Institute, 2012. http://www.cancerindia.org/Resources/GCRIAnnual%20Report-08-09-Text.pdf
28
Corporate Catalyst India, 2012
15
PWC , Global Pharma looks to India, 2010.
16
Surat Municipal Institute of Medical Education & Research, 2012. http://smimer.suratmunicipal.gov.in/
29 17
INDEXTb, Healthcare Sector Profile, 2011.
CBHI, Health Infraestructure, 2010.
18
Health and Family wealthfare department , Medical Cerfication of Cause of Death, 2010.
CHAPTER
3
30
Directorate of Economic and Statistics of Gujarat, 2008.
19
Indian Council of Medical Research, 2010.
31
Commissionerate of Health, Medical Services, Medical Education and Research of Gujarat State. Health Statistics Gujarat 2010-11. April 18th, 2012. http://www.gujhealth.gov.in/images/pdf/HEALTH_ STATISTICS_2010-11.pdf
20
Gordon, Sonia. Bernadett, Martha. Evans, Dennis. et al. Asian Indian Culture: Influences and Implications for Health Care, 2012. http://www.molinahealthcare.com/medicaid/ providers/common/pdf/asian%20indian%20 culture%20-%20influences%20and%20 implications%20for%20health%20care_material%20 and%20test.pdf?E=true
21
Sources and references
iNDEXTb, Healthcare Sectot Profile , Vibrant Gujarat, 2012. http://www.vibrantgujarat.com/images/pdf/ healthcare-details.pdf
32
Deloitte, 2008. “Medical Tourism”, 2012. http://www.deloitte.com/assets/DcomunitedStates/Local%20Assets/Documents/us_chs_ MedicalTourismStudy(3).pdf
33
Indian Brand Equity Foundation. Gems and Jewellery, 2012. http://www.ibef.org/industry/gemsjewellery.aspx
38
Gujarat Industrial Development Corporation,2009. Review of Blueprint for Infrastructure in Gujarat (BIG 2020), 2012. http://www.gidb.org/downloads/vol_1B_ summary_2020.pdf
39
GYAN GRAM Creating India’s Health Knowledge Cluster was printed in May 2012. CONTACT: + 52 (55) 5264 6235 www.scientika.mx contacto@scientika.mx
CONTACT: +525552646235 contacto@scientika.mx www.scientika.mx
Mexico City 2012