“100% literacy Saar,” proclaims a popular advertisement about Kerala. We pride ourselves on being a highly educated society. But does education automatically translate into innovation? More importantly, do we cultivate curiosity, critical thinking and a culture of risk-taking - key ingredients for meaningful scientific progress?

The Innovation Deficit

A glance at major scientific contributions from Kerala in the past few decades reveals a sobering truth: we’ve lagged in producing pioneering research - whether in basic science, translational medicine or clinical breakthroughs. Despite having brilliant individuals and reputable institutions, Kerala rarely features on the national or global map when it comes to impactful science. The reasons are many, and here is my humble take on them.

1) Vision: The Need for Institutional Dreamers
Scientific advancement requires a long-term, ambitious vision - one that stretches beyond electoral cycles and funding periods. Visionaries who build institutions and ecosystems often find themselves constrained. In Kerala, we neither celebrate merit adequately nor support institutional builders with the freedom and resources they need. Where such talent exists, it is often left to navigate bureaucratic hurdles with little institutional backing.

2) Team Science: Breaking Down Silos
Modern science thrives in collaborative ecosystems. Translational research, especially in cancer, demands constant exchange among basic scientists, clinicians, and technologists. Unfortunately, collaboration across disciplines and institutions remains the exception rather than the norm in Kerala. I’ve rarely seen a basic scientist shadow a clinician in a hospital ward - or a physician visiting a lab bench to understand ongoing experiments. Silos persist, reinforced by institutional and hierarchical boundaries.

3) Hierarchy: A Cultural Obstacle
Kerala’s scientific and academic culture is deeply hierarchical. The ingrained “yes sir/madam” attitude is antithetical to good science. True innovation arises when young minds are encouraged to challenge, question, and critique. A professor from the U.S. once told me her first goal with new post-docs is to unlearn their fear of authority - only then do they start articulating fresh, bold ideas with clarity and conviction. We must embrace that mindset here.

4) Risk-Taking: Embracing Failure
Our society glorifies success and shuns failure. But failure is an essential component of science. Great discoveries are often the result of failed hypotheses and experiments. Kerala needs to foster an environment where researchers and clinicians are encouraged to take calculated risks - not on roads, but in labs and clinics, within ethical and regulatory frameworks.

5) Funding: The Lifeblood of Research
Transformative science is resource-intensive. While some funds exist for research, especially through central agencies, the availability of financial support for bold, high-risk/high-reward ideas is still abysmally low. Kerala must create state-level mechanisms to identify and back innovative cancer research initiatives - particularly those rooted in our regional healthcare challenges and patient realities.

6) Universities: From Ivory Towers to Innovation Hubs
Globally, universities are the crucibles where revolutionary ideas take root and start-ups are born. In Kerala, universities rarely take on this role. Entrepreneurial spirit is stifled, and private-public partnerships are viewed with suspicion. Institutional inertia and regulatory red tape prevent cross-sectoral dialogue and knowledge exchange. We need to foster healthy competition among our research institutions to drive both excellence and accountability.

7) A Science-Driven Society and Polity
Our collective response to COVID-19 was telling - we clutched at pseudoscience, promoted unproven remedies, and shared misinformation without a second thought. Scientific temper - the backbone of a rational society - is in crisis. We need to build a society that values evidence over anecdote and inquiry over ideology. This requires sustained investment in public science education and political will that is aligned with scientific consensus.

In Conclusion

These reflections are neither exhaustive nor definitive. They are shaped by experience and observation. Kerala has the talent, the literacy, and the institutional legacy to lead in cancer research and beyond. But we need to recalibrate our systems, our incentives, and our culture. If you agree or disagree, I welcome your thoughts. Let’s build this vision together.