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Subject: Social Justice

  • In IIT, student death and a reckoning

    Why in the News

    A second-year BTech student at the Indian Institute of Technology (IIT) Bombay took his life hours after he was allegedly found adopting unfair means in an examination. Following student agitation, the institute has suspended the dean who reported him. Faculty members have rallied behind their colleague. The death comes a month after the death by suicide of an MSc student at IIT-Delhi, which set off weeks of protest and questions about the responsibilities of an institution towards those in its care. The family of the IIT-Bombay student has alleged caste discrimination. The contested point is whether a campus can hold academic integrity and a duty of care at the same time.

    Why is individual resilience the wrong frame for these deaths?

    1. Endurance already demonstrated: Students who clear these competitive entrance examinations have proved a formidable capacity for endurance, so a want of resilience does not explain the outcome.
    2. Scale of the pattern: Between 2006 and 2026 there have reportedly been over 170 student deaths across various IIT campuses, which makes this a recurring institutional outcome rather than a set of individual failures.
    3. The actual question: What is at issue is the old imagination of authority in premier campuses, which have become more socially and culturally diverse than ever before.

    How has the social composition of premier campuses outrun their institutional culture?

    1. What diversity brings in: A more diverse intake carries different experiences of class, caste, language, aspiration and vulnerability into the same classroom and hostel.
    2. New forms of exclusion: Diversity without a corresponding shift in institutional culture creates fresh exclusions rather than removing old ones.
    3. Design of the institution: These campuses were built principally around teaching, testing, rigour and discipline, and that design has no place to receive what a changed student body reports.

    Why can a counsellor’s office not address the change on campus?

    1. A structural change met with an addition: A system organised around examination and discipline cannot absorb a change in who its students are through the addition of a counsellor’s office alone.
    2. What students are reporting: Many students are away from home for the first time and are describing isolation, stigma and fear, which are conditions of the campus rather than clinical complaints.
    3. Where the listening has to happen: Professors and administrators are the people placed to hear this, so the response has to sit inside the academic relationship and not only beside it.

    Where does the faculty sit between accountability and compassion?

    1. The disciplinary act and its consequence: The dean who reported an examination irregularity was suspended after student agitation, while faculty members rallied behind him, so the same act was read as duty by one side and as cause by the other.
    2. Crises they were not trained for: Faculty work inside a system of administrative protocol and are expected to anticipate crises for which they received no training.
    3. The clarity they lack: Faculty have no settled statement of what is expected of them when a student is in distress.
    4. The assurance they lack: A decision taken in a student’s best interest and in line with guidelines carries the risk of being used to scapegoat the person who took it.

    Challenges to anchoring academic excellence in student wellbeing

    1. Caste and hierarchy inside the department: Counselling and grievance machinery does not reach the hierarchy that operates between a student and the people who grade him. Eg. The deceased student’s family has alleged caste discrimination.
      The Fix: Conduct a frank institutional reckoning with caste and hierarchy as a standing exercise, separate from the grievance process.
    2. Response confined to the aftermath: Institutional change is attempted in the sound and fury that follows a death and not before one. Eg. The IIT-Delhi death produced weeks of protest before the question of institutional responsibility was asked.
      The Fix: Make meaningful student representation ordinary institutional practice, so distress reaches the administration without a tragedy to carry it.
    3. Integrity procedure without a care protocol: Reporting examination misconduct and responding to a student in distress are handled by the same staff under a single disciplinary rulebook. Eg. A report of unfair means was made and the institution had no parallel process for what followed it.
      The Fix: Write guidelines that preserve academic integrity alongside strong counselling and grievance mechanisms, so one report triggers both tracks.
    4. Purpose narrowed to high performers: An institution of excellence measures itself by what its best students achieve, which leaves failure unaccommodated. Eg. Both deaths involved students at the point of academic or disciplinary difficulty rather than at the point of selection.
      The Fix: Define the mentoring mandate to cover the student who fails, so that failure is survivable inside the institution.

    Conclusion

    Two institutions are being asked to hold accountability and compassion in the same set of rules, and they currently have a language for only one of them. The suspension of one office holder settles nothing, because the difficulty is that a disciplinary system and a duty of care are running on the same staff with no protocol connecting them. What remains unresolved is who is answerable when a procedure correctly followed ends in a death. The measure to watch is whether the IITs issue a distress response protocol that sits beside their integrity rules rather than beneath them.

    Matching Previous Year Question

    “[2014, GS2, 12.5 marks] Should the premier institutes like IITs/IIMs be allowed to retain premier status, allowed more academic independence in designing courses and also decide mode/criteria of selection of students. Discuss in light of the growing challenges.”

  • How to ensure hospitals don’t cheat patients

    Why in the News

    Maharashtra’s Food and Drug Administration (FDA) has released purchase and billing comparisons for medical items sold by hospitals, showing that a drip set costing a hospital Rs 11 carries a printed price of Rs 325. The figures follow an audit of the bills of critical patients at private hospitals across Maharashtra, facilitated by Jan Arogya Abhiyan. A Department of Pharmaceuticals committee chaired by Sudhansh Pant had recorded in 2016 that high maximum retail prices were “a tool to cheat the helpless consumer”, and had recommended capping trade margins on all medicines and implants. Statutory price regulation still reaches only 18 per cent of medicines, so the gap between what a hospital pays for an item and what it bills the patient is set by the manufacturer’s printed price rather than by a regulator.

    What is the trade margin on a medicine?

    1. Trade margin: The difference between the price at which a hospital or a chemist buys a medicine or a consumable and the maximum retail price (MRP) printed on the pack, which is what the patient pays.
    2. Who sets the ceiling: For a product outside statutory price control the manufacturer prints the MRP itself, so the margin available to the seller is decided at the point of manufacture and not by a regulator.
    3. What price control actually covers: The Drug (Prices Control) Order lets the National Pharmaceutical Pricing Authority (NPPA) fix a ceiling price for formulations in the National List of Essential Medicines. Formulations outside that list carry only a cap on the annual price increase a manufacturer may take.
    4. Why an in-patient bill is different: A hospital both dispenses the item and bills for it, so the margin a chemist would earn is captured inside the hospital bill and the patient has no comparison to make.

    How large is the gap between what a hospital pays and what a patient is billed?

    1. Consumables at the regulator’s own count: A syringe bought for under Rs 7 is marked for sale at Rs 57.
    2. Compliance with the pandemic markup limit: Not one of the 46 medicine brands examined in the audit was charged within the limit of 10 per cent markup on purchase price that was fixed during the pandemic.
    3. Spread of the overcharging: For nearly half the medicines examined, patients paid more than 150 per cent above what the hospital had paid.
    4. Named medicines: A paracetamol drip bought for about Rs 33 was billed at Rs 408. An antibiotic injection bought for about Rs 180 was billed at Rs 950.
    5. The common range: Margins most commonly ran between 200 and 400 per cent.
    6. Consumables run higher than medicines: A drip set bought for about Rs 12 is typically billed at Rs 160 and sometimes at Rs 270. An oxygen mask costing about Rs 55 can be charged up to Rs 570.

    Why has the 2016 recommendation to cap trade margins not changed billing?

    1. The committee’s finding on MRP: Fixing the MRP was recorded as “free for all and largely arbitrary in which the consumer is the net loser”, which locates the defect in the printed price itself rather than in any individual seller.
    2. The recommended cap: Trade margins on all medicines and implants, price-controlled or not, were to be capped between 35 per cent and 50 per cent depending on the product’s price.
    3. Coverage the cap would have had: The recommendation applied to items outside price control as well, which is where the largest margins sit.
    4. Ten years without action: The recommendations were not implemented and patients continue to pay unjustified margins on many medicines and consumables, which contributes to medical impoverishment.

    What three steps does the proposal put forward?

    1. Purchase price on the bill: State FDAs can direct every private hospital to print, for medicines and consumables above a set value, both the price the hospital paid and the price it is charging, which gives the patient the ground to seek a discount or to buy from another source.
    2. Statutory price regulation extended: The Centre should extend price regulation to all essential medicines and medical consumables, since the present 18 per cent coverage is applied in a manner that is often over-permissive. This requires amendments to the Drug (Prices Control) Order, with the Department of Pharmaceuticals and the NPPA carrying it.
    3. A patient right already in force: Maharashtra’s FDA ordered in 2016, and again in 2022, that hospitals cannot force admitted patients to buy medicines only from the hospital pharmacy. The National Consumer Commission has called such compulsion an unfair trade practice, the right appears in the National Patients’ Rights Charter, and every hospital must display it.

    Challenges to statutory price control of medicines

    1. Scope tied to a list: A ceiling price binds only a formulation carried on the National List of Essential Medicines, so a product that moves outside the list escapes it. Eg. The list was revised in 2015 and again in 2022, leaving a long interval in which newer formulations stayed uncontrolled.
      The Fix: Fix a statutory revision cycle for the list, so a new formulation is assessed for inclusion on a schedule rather than at discretion.
    2. Devices and consumables outside formulation control: A syringe, a drip set or a mask is not a formulation, so it falls outside a price control system built around medicines. Eg. The NPPA had to notify cardiac stents and knee implants separately in 2017 to bring each under a ceiling price.
      The Fix: Bring consumables and implants under a single trade margin ceiling that applies by value rather than by product notification.
    3. Trade margin rationalisation used selectively: The regulator has capped trade margins on small sets of products rather than across the board, so the instrument exists without reach. Eg. In 2019 the NPPA capped trade margins at 30 per cent on 42 non-scheduled anti-cancer medicines.
      The Fix: Publish the purchase-to-billing margin for each notified product from hospital procurement records, so a cap is auditable rather than self-declared.
    4. Enforcement sits with understaffed state machinery: A ceiling price is notified centrally but detected at the point of sale by state drug inspectors, whose sanctioned strength is low. Eg. The Mashelkar Committee of 2003 recorded that state drug control departments were understaffed and recommended a centralised national drug authority.
      The Fix: Publish state-wise inspector strength and the amount of overcharging recovered against notified ceiling prices every year, so weak enforcement is visible before it is litigated.

    Conclusion

    Price regulation in India has been built around what a medicine may cost, not around what a seller may add to it. The patient’s money goes into the margin, so the margin is the variable that has to be capped, and a cap on it works whether or not the product is on any list. The test now is whether the Department of Pharmaceuticals acts on a margin cap that has been before it for a decade, or leaves billing disclosure to whichever state regulator chooses to order it.

    Health financing in India

    1. Public health expenditure: Government spending on health stands at 1.9 per cent of GDP, against the National Health Policy, 2017 target of 2.5 per cent, with the Centre’s own share at 0.29 per cent of GDP.
    2. Public and private together: Combined health expenditure is 3.8 per cent of GDP, so most health spending in India is private spending.
    3. Out-of-pocket expenditure: Payments households make directly at the point of care, without insurance or public cover absorbing them, fell from 55 per cent of health spending in 2017-18 to 39.4 per cent in 2021-22.
    4. The missing middle: About 30 per cent of the population carries no health insurance of any kind, being above the eligibility line for public cover and below the reach of private cover.

    Government Initiatives for affordable medicines and care

    1. Pradhan Mantri Bhartiya Janaushadhi Pariyojana: Run by the Department of Pharmaceuticals, it sells quality generic medicines at low prices through Jan Aushadhi Kendras, aimed at patients paying for medicines themselves.
    2. AMRIT outlets: Affordable Medicines and Reliable Implants for Treatment stores inside government hospitals sell cancer and cardiovascular medicines, implants and devices at discounted prices.
    3. Ayushman Bharat Pradhan Mantri Jan Arogya Yojana: Provides hospitalisation cover to eligible households at empanelled public and private hospitals, with over 43.52 crore Ayushman cards created.
    4. Ayushman Vay Vandana: Extends a Rs 5 lakh health cover to citizens aged 70 and above irrespective of income, with over 93 lakh cards issued.

    Back2Basics: National Pharmaceutical Pricing Authority

    1. What it is: An attached office of the Department of Pharmaceuticals under the Ministry of Chemicals and Fertilizers, set up in 1997 as the price regulator for medicines.
    2. Core function: It fixes and revises the ceiling prices of scheduled formulations and monitors the prices of medicines that are not under ceiling control.
    3. Recovery power: It can demand the amount overcharged, along with interest, from a company that sells above a notified ceiling price.
    4. Policy role: It advises the Centre on pricing policy for drugs and on changes to the Drug (Prices Control) Order.

    Matching Previous Year Question

    “[2024, GS2, 15 marks] In a crucial domain like the public healthcare system, the Indian State should play a vital role to contain the adverse impact of marketisation of the system. Suggest some measures through which the State can enhance the reach of public healthcare at the grassroots level.”

  • For student well-being, rethink the campus, not just the student

    Why in the News

    Recent deaths of students at the Indian Institute of Technology (IIT) Delhi and IIT Bombay have reopened the question of what an educational institution owes students beyond teaching and evaluation. IIT Delhi has constituted an external inquiry committee. The IIT Bombay director has said a committee would examine the death and students’ concerns about representation and support services. Campus well being is treated as a clinical matter outsourced to counsellors and therapists, while the rules, hierarchies, evaluation systems and grievance procedures that shape daily campus life stay unexamined. The World Health Organization (WHO) places mental health inside social, economic and physical environments, and the 2026 interim report of India’s National Task Force on Student Mental Health and Suicide Prevention ties student well being to academic pressure, discrimination, financial hardship, institutional culture, distrust and faculty preparedness. What is contested is whether universities are willing to examine the conditions they themselves create.

    Why does a counselling first and skills first model fall short?

    1. Limits of the medical analogy: A medicine acts on a biological process while the surrounding social situation stays unchanged, so the analogy cannot carry a complete theory of well being.
    2. Distress relocated inside the student: Once professional services become the institution’s primary measure of well being, the university presents itself as a neutral background to the student’s private difficulty.
    3. Counselling cannot remove the pressure: Students negotiate academic overload, discrimination, poor hostel infrastructure, career anxiety and unresponsive administration, and counselling helps a student respond to these rather than removing them.
    4. Well being reframed as a personal skill: Time management, emotion regulation, sleep, exercise and resilience are presented as capacities students must acquire on their own.
    5. Where the skills stop working: Time management cannot solve an impossible workload, mindfulness cannot make an opaque grading system transparent, and positive thinking cannot make a compromised grievance process trustworthy.

    What institutional conditions actually shape student well-being?

    1. The ordinary machinery of the campus: Rules, hierarchies, classrooms, hostels, evaluation systems, grievance procedures and the everyday exercise of authority determine how people live on a campus.
    2. Discipline as the organising idea: Educational experience remains shaped by discipline and steep hierarchies rather than by freedom, equity, trust and empathy.
    3. Dissent read as misconduct: A student who dissents is liable to be labelled as indiscipline, political activism or disrespect.
    4. The decisions that settle the question: Whether a student can question a grade, disagree with a supervisor, express dissent, protest, or take part in decision making is what an institution’s well being claim rests on.
    5. Faculty and administrators hold the lever: Ensuring student well being is a shared responsibility of faculty and administrators, and it is routinely overlooked in practice.

    How do authoritative frameworks locate the causes of student distress?

    1. WHO framing: Mental health sits within social, economic and physical environments, and prevention must address individual, social and structural determinants together.
    2. National Task Force finding: The 2026 interim report connects student well being with academic pressure, discrimination, financial hardship, institutional culture, distrust and faculty preparedness.
    3. Convergence of the two: Both place the causes outside the individual student, which is the opposite of where campus practice places them.
    4. Existing guidance is already sufficient: Indian higher education carries enough guidelines to know that student well being cannot be separated from academic pressure and institutional culture.

    Where does the university’s model of authority contradict itself?

    1. Adults for obligation, children for voice: Students are treated as adults when fees, performance and responsibility are demanded, and as children when autonomy, voice or due process become inconvenient.
    2. Care language over paternal authority: The deeper problem appears where universities speak the language of care while retaining a paternal model of authority.
    3. Harshness defended as formation: Harshness is justified as character building, and obedience is conflated with respect.
    4. Asymmetric reciprocity: The vocabulary of the guru shishya relationship is misused once reciprocity disappears, so respect moves upward while correction and anger move downward.
    5. Forms the distress takes: Public shaming, arbitrary penalties, exclusion from opportunities, hostile communication and the use of evaluation to settle interpersonal conflict make the educational experience itself distressing.

    What would a well-being test for the classroom look like?

    1. Teaching is not outside the policy: Administrators and faculty commonly assume well being policy begins outside the classroom, as though teaching and evaluation do not bear on it.
    2. The operative test: A classroom passes where students are empowered to ask for reasons, admit uncertainty, make a mistake and disagree with a teacher.
    3. Protection after speaking: The same test requires that students can criticise or protest the administration and report unfair treatment without expecting retaliation.
    4. Scope of the claim: Universities cannot eliminate every source of suffering, students are not always right, and academic standards are not abandoned whenever conflict appears.

    What institutional redesign is proposed?

    1. Students as rights bearing adults: Students should be active participants in institutional governance rather than being confined to ornamental roles.
    2. Governance membership: Alumni and students should be part of the governance framework through board membership.
    3. Role specific training: Faculty and student affairs teams need training to recognise distress, protect confidentiality, respond without humiliating, understand bias and follow crisis protocols, and to accept that differences of opinion are students’ rights.
    4. Disciplinary process redesigned: A high stress disciplinary encounter should open with a humane conversation setting out the institutional support available, followed by further conversations rather than a single performative step.
    5. An annual well being audit: Universities must be willing to undergo an annual student well being audit, and a few principles matter more than a long list of initiatives.

    Challenges to institutional reform on student well-being

    1. Professional capacity is missing: An institutional model still needs trained counsellors at the point of crisis, and the national supply is far below requirement. Eg. India has about 0.75 psychiatrists per 100,000 people against the WHO norm of 3 per 100,000.
      The Fix: Tie a fixed counsellor to student ratio and an in house student wellness team to accreditation, so capacity is a condition of approval rather than a discretionary spend.
    2. Grievance machinery exists without trust: A redress body that students do not believe in produces silence rather than complaints, and silence is read by the institution as the absence of a problem. Eg. The University Grants Commission (Redressal of Grievances of Students) Regulations, 2023 require every higher educational institution to appoint an ombudsperson.
      The Fix: Publish anonymised annual data on grievances filed, timelines and outcomes, so disposal is visible rather than asserted.
    3. Discrimination is embedded in supervision and hostel life: Bias in supervision, allocation and everyday campus life falls on specific groups and shows up as dropout rather than as a complaint. Eg. High dropout at postgraduate and doctoral levels has been attributed to institutional bias, as argued after the Rohith Vemula case at the University of Hyderabad.
      The Fix: Give equal opportunity cells a reporting line to the governing board rather than to the administration they are meant to examine.
    4. Evaluation doubles as an instrument of authority: Discretionary grading and supervisory control over a thesis timeline give a single individual decisive power over a student’s future. Eg. Doctoral progression in most Indian universities rests on a single supervisor’s recommendation with no standing appeal route.
      The Fix: Mandate published grading rubrics and a second examiner appeal route for both coursework and doctoral progress reviews.
    5. Well being carries no measurable accountability: Nothing currently attaches an institutional consequence to a campus that produces distress, so reform stays voluntary. Eg. The Supreme Court in the Sukdeb Saha case recognised mental health as part of the right to life under Article 21.
      The Fix: Fold the annual well being audit score into National Assessment and Accreditation Council grading, so the audit carries a funding and reputational consequence.

    Conclusion

    Indian higher education has never lacked the diagnosis. What it lacks is any willingness to accept that the conditions producing student distress are its own design choices about authority, evaluation and voice. Treating counselling as the answer keeps those choices out of scrutiny at the exact point they are most visible. The marker to watch is whether the National Task Force’s final report converts its findings into audited institutional obligations rather than another set of advisory guidelines.

    Student mental health in India

    1. Scale of the system: India runs the world’s second largest higher education system, with total enrolment estimated at 4.65 crore in 2026 against 3.42 crore in 2014-15.
    2. Suicide burden: India accounts for nearly one third of global suicides, and suicide is the leading cause of death in the 15 to 29 age group.
    3. Treatment gap: The treatment gap for common mental disorders runs between 70 and 90 per cent, and under 1.5 per cent of the health budget goes to mental health.
    4. Statutory footing: The Mental Healthcare Act, 2017 replaced the 1987 law, created a right to mental healthcare and decriminalised attempted suicide.

    Government Initiatives on student and youth mental health

    1. Manodarpan: A Ministry of Education initiative carrying advisory guidelines for students, teachers and faculty, a national database of counsellors, a toll free helpline and a handbook on psychosocial support.
    2. Tele MANAS and Kiran: Tele MANAS provides a round the clock tele mental health service through State cells, and Kiran is a toll free helpline for people in psychological distress.
    3. National Suicide Prevention Strategy, 2022: The first national strategy of its kind, targeting a 10 per cent reduction in suicide mortality by 2030.
    4. District Mental Health Programme: Operating under the National Mental Health Programme, it delivers counselling, outpatient care, suicide prevention and ten bedded inpatient facilities at the district level.

    Back2Basics: National Task Force on Student Mental Health and Suicide Prevention

    1. Origin: It was constituted by the Supreme Court in 2025 to examine the causes of student suicides in higher educational institutions.
    2. Composition: It is chaired by a former judge of the Supreme Court and includes mental health professionals and academic administrators.
    3. Mandate: It is required to identify gaps in the mental health support available on campuses and recommend preventive and remedial measures.
    4. Status: It released an interim report in 2026, and its recommendations are to inform binding directions to higher educational institutions.

    Matching Previous Year Question

    “[2014, GS2, 12.5 marks] Should the premier institutes like IITs/IIMs be allowed to retain premier status, allowed more academic independence in designing courses and also decide mode/criteria of selection of students. Discuss in light of the growing challenges.”

  • A dangerous dose of deception

    Why in the News

    A joint police and drugs control raid on a farmhouse in C.K. Tandya village in South Bengaluru district has uncovered a unit repackaging low cost, substandard and expired pharmaceutical formulations into fresh vials under counterfeit labels of established companies. More than 5,600 vials of counterfeit antibiotic injections were recovered, with the total seizure valued at about Rs 4.91 crore. Police say the suspect medicines have reached more than 90 hospitals and clinics in Karnataka and other States. The unit was found because an agricultural labourer reported a heap of dumped medical waste to the local police, not because a regulator detected it. Section 17B of the Drugs and Cosmetics Act, 1940 already defines a spurious drug and Section 18 already prohibits its manufacture and sale, so the failure sits in enforcement capacity and in the price gap that creates a market for fakes.

    What does the law define as a spurious drug?

    1. The definition: Section 17B of the Drugs and Cosmetics Act, 1940 defines a spurious drug as one sold under a name belonging to another drug, one imitating another product so as to deceive, or one falsely purporting to be the product of a manufacturer it is not.
    2. The prohibition: Section 18 bars the manufacture, sale, stocking, distribution and exhibition for sale of a spurious or misbranded drug.
    3. Why relabelling is caught: The offence attaches to the label and the representation, so moving a substandard or expired formulation into a new vial carrying another firm’s label is itself the offence.
    4. Who enforces it: Drug inspectors appointed by the State drugs control departments carry out inspection, sampling and prosecution, against the central standards the Act lays down.

    How did the network operate?

    1. The premises: The unit ran from a rented farmhouse of nearly eight acres behind a compound wall on the outskirts of the village, whose owners live in Bengaluru and seldom visited it.
    2. The inputs: The operators procured low cost, substandard or expired pharmaceutical formulations from other States.
    3. The process: Those formulations were transferred into fresh vials. Counterfeit labels and packaging of established pharmaceutical companies were then applied so the product would pass as genuine inside the supply chain.
    4. The movement of goods: Villagers had seen men entering and leaving on a scooter with no number plate, and courier and e commerce delivery vehicles making regular trips to the secluded location.
    5. The evidence recovered: Police seized ledgers, invoices, mobile phones and other records that set out the supply chain, and a Special Investigation Team (SIT) was constituted to work it.

    How did the counterfeit drugs reach hospitals?

    1. The distributor: The farmhouse operators supplied Krupa Healthcare, a wholesale pharmaceutical distributor on a commercial street in Bengaluru, which then distributed the stock onward.
    2. The price incentive: Some of the medicines were offered to hospitals at discounts of up to 50 percent.
    3. The sales push: The distributor employed more than 15 medical representatives to promote the medicines and offered commissions to push the discounted stock to private hospitals and medical centres.
    4. The product range: The counterfeits were not limited to antibiotics and included critical care injections and cancer medicines.
    5. The inter State reach: A joint force carried out simultaneous searches across Karnataka, Himachal Pradesh, Haryana, Tamil Nadu, Maharashtra and Telangana, and a person police describe as a key figure in the network is currently outside the country.

    What does a counterfeit drug do to a cancer patient’s treatment?

    1. Dependence on exact dosing: Cancer treatment turns on the right drug at the right dose at the right time, so any compromise in authenticity or quality directly affects the course of treatment.
    2. Failure that is invisible: A counterfeit, substandard or expired drug may not work as intended, which delays disease control and allows the cancer to progress. The absence of response is often read as the cancer becoming resistant rather than as a drug failure.
    3. Unknown contents: A counterfeit product may carry an incorrect dose, inactive ingredients, contaminants or substances producing unexpected side effects, which is more dangerous for a patient already on multiple cancer medicines.
    4. The money already spent: Families reported paying more than a lakh and a half rupees for a single immunotherapy vial and lakhs more across the full course, with no way now of establishing whether what was administered was genuine.
    5. The decision a patient cannot make: A patient who cannot verify the authenticity of the medicine has no basis on which to decide whether to continue or discontinue treatment.

    What has the State disclosed and what has it withheld?

    1. What was published: The State government has published the list of antibiotics seized during the raid.
    2. What has not been released: The names of the oncology drugs, the hospitals and clinics that may have received the stock, and the names and batch numbers of the counterfeit medicines linked to serious illnesses remain undisclosed.
    3. The stated reason: The Karnataka Minister for Health and Family Welfare has said the full list has been communicated to the Union government and all State governments, and that nothing will be revealed while the Special Investigation Team is seized of the matter.
    4. What disclosure would enable: Hospitals need the product names and batch numbers to identify exposed patients, and a specialist in healthcare law has put the position that a hospital then carries an ethical duty to inform those patients.
    5. The cost of delay: A detailed investigation takes time, and the suspect stock can continue to reach patients while it runs.

    Why does the regulatory system not catch this earlier?

    1. An under equipped inspectorate: Drug inspectors are the first line of enforcement and are not adequately equipped for the volume and sophistication of the task.
    2. Weak deterrence: Punishment for wrongdoing is not stringent enough to deter an operation working on these margins.
    3. Price creates the market: The high cost of medicines, cancer drugs in particular, sustains a parallel market for cheaper counterfeit versions, so access and affordability are the underlying issue.
    4. Procurement outside the manufacturer’s chain: A hospital or insurer that sources a drug from outside the manufacturer’s own distribution chain loses the ability to verify origin, which is why some oncology providers refuse externally supplied drugs outright.
    5. No continuous surveillance: There is no standing system that works to prevent drug rackets and reports publicly on its own findings, so detection depends on an incident being noticed by someone.

    Challenges to drug quality regulation in India

    1. A fragmented regulator: Licensing and routine enforcement sit with separate State drugs control departments while standards are set centrally, so a firm constrained in one State can operate through another. Eg. The searches in this case ran across six States because the procurement, repackaging and distribution legs each sat in a different jurisdiction.
      The Fix: Move manufacturing licensing for all formulations to a single central licensing authority, so one regulator holds the complete record for every unit.
    2. Vacancies in the inspectorate: Sanctioned strength of drug inspectors is low against the number of manufacturing units, wholesalers and retail outlets each inspector is expected to cover. Eg. The expert committee on spurious drugs and drug regulatory issues, which reported in 2003, recommended a substantial expansion of the central and State drug regulatory workforce and its laboratory infrastructure.
      The Fix: Fix a statutory inspector to outlet ratio, fund recruitment against it, and publish the shortfall annually.
    3. No end to end traceability: There is no mandatory track and trace across the domestic supply chain, so a vial’s route from manufacturer to hospital cannot be reconstructed after the fact. Eg. Barcoding and quick response code requirements under the Drugs Rules currently apply to a list of top selling brands and to exports rather than to the entire domestic market.
      The Fix: Extend unique identifier coding with a public verification interface to every prescription formulation, and require hospitals to scan each consignment on receipt.
    4. Testing capacity is the bottleneck: A seized sample becomes a prosecution only after a government analyst’s report, so laboratory throughput limits how many samples can be drawn in the first place. Eg. Risk based inspections by the Central Drugs Standard Control Organisation (CDSCO) have repeatedly flagged units failing good manufacturing practice, with action turning on laboratory confirmation.
      The Fix: Fund accredited third party laboratories for routine screening, and reserve government analyst capacity for prosecution grade testing.
    5. The price gap sustains demand for fakes: Patented oncology therapies are priced beyond most households, so a steeply discounted vial is attractive even where its origin is doubtful. Eg. The National Pharmaceutical Pricing Authority caps prices largely for medicines in the National List of Essential Medicines, which leaves most patented cancer therapies outside price control.
      The Fix: Bring high burden oncology therapies under price control or compulsory licensing, so an affordable legitimate option exists at the point of prescription.
    6. Hospital verification has no auditable standard: Hospitals carry a legal duty to procure responsibly and verify authenticity, with no prescribed verification protocol they can be audited against. Eg. The counterfeits in this case entered through a licensed wholesale distributor rather than through an obviously unlicensed channel.
      The Fix: Prescribe a mandatory supplier qualification and batch verification protocol as a condition of hospital licensing, auditable by the State drugs controller.

    Conclusion

    Every part of the enforcement chain in this case worked after the event. The offence was already defined, the prohibition already existed, and what was absent was anyone looking before the waste was dumped. The unresolved question is disclosure, since the State holds the product names, the batch numbers and the list of affected hospitals, and is withholding them while the investigation runs. The patients with the strongest claim to that information are the ones still under treatment, and whether the list reaches them before the case concludes is where the duty to the patient is tested against the duty to the prosecution.

    Back2Basics: Central Drugs Standard Control Organisation (CDSCO)

    1. What it is: The national drug regulatory authority of India, functioning under the Directorate General of Health Services in the Ministry of Health and Family Welfare.
    2. Who heads it: It is headed by the Drugs Controller General of India (DCGI), who approves new drugs, clinical trials and licences for import.
    3. What it regulates: It approves new drugs, vaccines, blood products and medical devices, and lays down the standards that the Drugs and Cosmetics Act, 1940 is enforced against.
    4. How it is organised: It is headquartered in New Delhi and works through zonal, sub zonal and port offices along with central drug testing laboratories.

    Matching Previous Year Question

    “[2024, GS2, 15] In a crucial domain like the public healthcare system, the Indian State should play a vital role to contain the adverse impact of marketisation of the system. Suggest some measures through which the State can enhance the reach of public healthcare at the grassroots level.”

  • NEET-SS qualifying percentile will be reduced to 30: govt.

    Why in the News

    The Centre has agreed to reduce the qualifying percentile for National Eligibility cum Entrance Test Super Speciality (NEET-SS) seats from the existing 50th percentile to the 30th percentile for a proposed Special Stray Vacancy Round. It has also agreed to return 40 vacant in service seats pertaining to Tamil Nadu to the State government. The position was recorded before a Supreme Court Bench headed by Justice P.S. Narasimha, and follows the Centre’s own statement that 1,857 super speciality seats remain vacant after the second round of counselling. The contest is over how far the bar should fall. The petitioner association sought a zero cut off percentile, as had been done in the previous two years, while the Centre has stopped at 30.

    What is NEET-SS?

    1. Purpose: It is the single national entrance examination for admission to super speciality medical courses, meaning the DM and MCh programmes taken after a postgraduate degree.
    2. Qualifying percentile: Eligibility is fixed by a percentile cut off rather than a fixed mark, so the bar moves with the performance of the candidate pool in that year.
    3. Counselling structure: Admission runs through successive counselling rounds, with seats left unfilled after the regular rounds handled through stray vacancy rounds.

    What has the Centre agreed to change?

    1. The percentile cut: The qualifying percentile for NEET-SS is to fall from the 50th percentile to the 30th percentile, limited to the purpose of the proposed Special Stray Vacancy Round.
    2. The stated reason: The change is intended to ensure that available super speciality seats do not remain vacant and that available training capacity is optimally utilised.
    3. Who becomes eligible: Candidates securing the 30th percentile and above in NEET-SS become eligible to take part in the special stray vacancy round.
    4. How the position was reached: The Centre recorded that the matter had been reconsidered in consultation with the concerned stakeholders before the decision was taken.

    Why are super speciality seats going vacant?

    1. The vacancy count: 1,857 super speciality seats were lying vacant after the completion of the second round of NEET-SS counselling.
    2. Training capacity is the cost: A vacant super speciality seat is idle teaching capacity in a discipline with very few trained practitioners, which is the ground the Centre itself cites for lowering the bar.
    3. The demand for a zero cut off: The petitioner, the Tamil Nadu Medical Officers Association, sought a zero cut off percentile, pointing to the same relaxation having been granted in the past two years.

    What does the return of the Tamil Nadu in service seats settle?

    1. The reversion: 40 vacant in service seats pertaining to Tamil Nadu are to be reverted to the State government, a decision the Centre said was taken in compliance with Supreme Court orders.
    2. A bounded window: The reversion is for the limited purpose of enabling the State to conduct and complete its own stray vacancy round, over a period of one week.
    3. Upgradation permitted: The court additionally allowed Tamil Nadu to permit candidate upgradation during that one week special stray vacancy round.

    Challenges to filling seats by lowering the percentile

    1. A recurring relaxation becomes the norm: Reducing the bar every year turns an emergency measure into the standing eligibility threshold, so the percentile stops signalling anything about preparedness. Eg. A zero cut off percentile was applied in the two years before this one, and a zero cut off is what the petitioner sought again.
      The Fix: Fix the relaxation to the specific stray vacancy round by notification each year, with the regular rounds held at the standard percentile.
    2. Vacancy is concentrated, not general: Seats go unfilled in specific disciplines and specific institutions rather than across the board, so a uniform percentile cut does not target the shortage. Eg. Super speciality vacancies cluster in less preferred branches and in institutions away from metropolitan centres.
      The Fix: Publish discipline wise and institution wise vacancy data before each round so relaxation can be targeted at the branches actually going empty.
    3. In service and open quota seats move on different clocks: State in service seats and the all India pool are counselled separately, so a seat surrendered late in one stream cannot be recovered in the other. Eg. The 40 Tamil Nadu in service seats needed a court directed reversion and a separate one week State round to be usable at all.
      The Fix: Synchronise the State in service and all India counselling calendars so surrendered seats return to a common pool within the same round.
    4. Bond and service conditions deter takers: Compulsory service bonds and penalty clauses attached to super speciality seats reduce willingness to take a seat even when eligibility is not the barrier. Eg. Several States attach multi year rural or government service obligations with financial penalties to postgraduate and super speciality admissions.
      The Fix: Standardise bond duration and penalty ceilings across States so a candidate can compare obligations before choosing a seat.

    Conclusion

    The dispute is not about the merit bar as a principle but about whether the annual relaxation has become the real eligibility rule. The Centre has taken the percentile to 30 for a single stray round and returned the Tamil Nadu in service seats for a one week State round, while the petitioner’s demand for a zero cut off remains unaccepted. Whether the training capacity argument continues to justify a fresh cut each admission cycle is what the next counselling season will show.

    Back2Basics: The in service quota in medical admissions

    1. What it is: A reservation of postgraduate and super speciality seats for doctors already serving in State government health services.
    2. Purpose: It is designed to retain doctors in public service by linking higher specialisation to time served in government posts.
    3. Legal position: The Supreme Court in Tamil Nadu Medical Officers Association v. Union of India (2020) upheld the competence of States to provide in service reservation in postgraduate medical courses.
    4. Administration: In service seats are counselled by the State government, separately from the all India quota seats counselled centrally.

    Matching Previous Year Question

    “[2014, GS2, 12] Should the premier institutes like IITs/IIMs be allowed to retain premier status, allowed more academic independence in designing courses and also decide mode/criteria of selection of students. Discuss in light of the growing challenges.”

  • Care That Goes Beyond the Prescription

    Care That Goes Beyond the Prescription

    Why in the News?

    The Pradhan Mantri Bhartiya Janaushadhi Pariyojana (PMBJP) is expanding affordable healthcare beyond medicines through a wider basket of surgical, medical consumable and supportive-care products.

    Key Highlights

    • 20,000+ Janaushadhi Kendras across India.
    • Product basket as of August 2026:
      • 2,110 medicines
      • 315 surgicals, medical consumables and devices
    • Covers major therapeutic categories such as:
      • Cardiovascular
      • Anti-cancer
      • Anti-diabetic
      • Anti-infectives
      • Gastro-intestinal
      • Anti-allergic

    Affordability Impact

    • Sales during 2021-22 to 2025-26: ₹7,873.85 crore.
    • Estimated savings to citizens: ₹37,200 crore.

    Healthcare Beyond Medicines

    Janaushadhi Bachpan

    • Baby diapers and wipes
    • Baby feeding bottles
    • Manual breast pumps
    • Infant feeding tubes

    Monitoring and Recovery

    • Electrical nebulizers
    • Nebulizer masks
    • Glucometer test strips
    • Pulse oximeters

    Elderly and Dependent Care

    • Jan Aushadhi Swabhiman: adult diapers.
    • Focus on hygiene, comfort, mobility and caregiving.

    Products in Pipeline

    • Knee brace
    • Walker with sit-to-stand support
    • Medical steam vaporizer
    • Foot elevator pillow
    • Pregnancy back support belt
    • Cervical collar

    Important Full Forms

    • PMBJP: Pradhan Mantri Bhartiya Janaushadhi Pariyojana
    • JAK: Jan Aushadhi Kendra

    Prelims Quick Revision

    • PMBJP provides quality-assured generic medicines at affordable prices.
    • Distribution takes place through Janaushadhi Kendras.
    • The basket now includes medicines + surgicals + medical devices + consumables.
    • Janaushadhi Bachpan: infant-care products.
    • Jan Aushadhi Swabhiman: adult diapers.

  • Our healthcare boom hides a public-system deficit

    Why in the News

    The most revealing number in India’s healthcare record is government health expenditure at 1.43 per cent of GDP in 2022 to 2023, against the 2.5 per cent target set by the National Health Policy 2017. Almost every visible measure of healthcare has expanded, with medical colleges and seats multiplied, the footprint of the All India Institute of Medical Sciences (AIIMS) network widened, and Ayushman Bharat established as one of the world’s largest publicly funded health insurance programmes. The latest report of the Parliamentary Standing Committee on Health and Family Welfare finds a system still struggling with basic capacity, affordability and regulation. The tension is that expansion has been measured in inputs the state can count, while the outcome that decides the result, whether a family is less exposed when illness strikes, is set by financing the state has not provided.

    What does government health expenditure as a share of GDP measure?

    1. What the ratio counts: It measures spending on health by the Centre, the states and local bodies, set against the size of the economy, so it rises only when health spending grows faster than output does.
    2. Why the share and not the amount: An absolute figure grows every year with prices and with the economy, so only the share shows whether health is gaining or losing ground against competing claims on public money.
    3. The benchmark it is read against: The National Health Policy 2017 fixed 2.5 per cent of GDP as the target, and the distance between that and the actual figure is what the public system’s shortfall is measured by.

    Why has expanding medical education not fixed the distribution of care?

    1. The expansion is real: The number of medical colleges has risen to 818, and undergraduate medical seats have reached 1,28,875.
    2. The problem was never the count of doctors: It was where they practise, who can afford them, and whether the system has the infrastructure to use them.
    3. Specialists are missing where they are most needed: The Committee finds specialist shortages at rural community health centres of roughly 70 to 80 per cent.
    4. Facilities without a building: There are 17,788 sub centres with no building of their own.
    5. Education as a commercial sector: Medical education has itself become a major commercial sector, with private and public private partnership models playing an important role, and once medical seats become valuable commercial assets the integrity of the regulator becomes the live question.

    What does the private sector’s share of care cost a patient?

    1. Where care actually happens: Citing the National Sample Survey Office (NSSO) 80th round of 2025, more than 60 per cent of hospitalisations and around 70 per cent of outpatient care are serviced by the private sector.
    2. The price difference: Average hospitalisation expenditure is approximately Rs 6,631 in government hospitals, against Rs 50,508 in private hospitals.
    3. How the state imposes a cost without charging one: The state does not have to bill a patient to place the cost of private treatment on them, and only has to fail to provide a realistic public alternative.

    Why does insurance leave both prices and the missing middle unaddressed?

    1. What insurance has delivered: Ayushman Bharat has helped millions of families obtain hospital care they might otherwise have been unable to afford.
    2. Insurance pays the bill without controlling the price: If treatment costs Rs 5 lakh and insurance pays that amount, the patient is protected from immediate financial ruin while the healthcare system has still consumed the same sum.
    3. Someone eventually pays: If prices continue rising, the cost falls somewhere, on the government, the insurer, the employer or the patient.
    4. The missing middle: More than 40 crore Indians remain outside comprehensive financial protection, being too well off for the scheme and too poor for private cover.
    5. Out of pocket spending stays high: Such spending has fallen substantially and still accounted for 43.4 per cent of total health expenditure in 2022 to 2023.

    What is private capital buying, and what should the test of it be?

    1. Where the capital is going: Major transactions involving Manipal Health Enterprises, CARE Hospitals, KIMS, Rainbow Children’s Hospital and several diagnostic chains illustrate the growing appetite for healthcare assets.
    2. What attracts investors: Recurring demand, consolidation opportunities and the ability to build scalable chains.
    3. Capital is not the problem: India needs enormous investment, and the open question is what that investment actually produces.
    4. The tests to apply: Whether it creates capacity in under served districts, makes treatment cheaper and strengthens primary care, or instead acquires existing businesses, consolidates markets and pursues the most profitable segments.
    5. The standard proposed: The 2026 Lancet Commission Report on a Citizen-Centred Health System for India argues for a stronger publicly financed and publicly provided health system as the foundation of universal healthcare.

    Challenges to a publicly financed health system

    1. Spending is stuck below the policy’s own target: The share of public money reaching health has not moved to the level the policy set, so every other reform runs into a financing ceiling. Eg. Only around 40 per cent of public health funds go to primary care, against the National Health Policy 2017 target of two thirds.
      The Fix: Ring fence a rising share of the health budget for primary and preventive care, with an annual reporting requirement against the two thirds target.
    2. Health is a State subject and capacity varies sharply: Delivery depends on the state, so a single national design lands on very different administrative systems. Eg. Kerala’s decentralised public health system and Tamil Nadu’s doorstep care programme for the elderly and for patients with non communicable diseases have no counterpart in many states.
      The Fix: Tie central health transfers to state level outcome indicators rather than to expenditure alone, so building capacity is what gets rewarded.
    3. Public beds sit where the patients are not: Public capacity is concentrated in cities while most of the population is rural, so proximity rather than price decides who reaches care. Eg. 73 per cent of public hospital beds are in urban areas.
      The Fix: Make rural service a condition of subsidised medical education, with the posting tied to the district that lacks that specialty.
    4. Money collected for health does not reach health: A cess raised for a stated purpose does not arrive in the fund built for it, so the shortfall persists even where the revenue exists. Eg. The Comptroller and Auditor General has reported a gap of over Rs 43,000 crore in the transfer of health cess to the Pradhan Mantri Swasthya Suraksha Nidhi.
      The Fix: Make the transfer of the health cess to that fund automatic, and report the closing balance in the annual budget documents.
    5. Regulation of a commercialised sector is weak: Where private providers deliver most of the care, the state’s only lever over price and quality is a regulatory capacity it has not built. Eg. There is no national mechanism that caps the cost of high cost private procedures.
      The Fix: Enforce the Clinical Establishments (Registration and Regulation) Act, 2010 across states, with published standard treatment guidelines and rate ranges.

    Conclusion

    The expansion is real and it is being measured against the wrong thing. Counting colleges, seats, cards and institutions records what the state has built, and records nothing about whether a household can reach care it can pay for. The unresolved tension is that the public system is being asked to carry a universal promise on a share of national income that has not risen to meet it, while the private system it defers to sets the price. What to watch is whether that financing share moves, because every other reform in this area sits downstream of it.

    Public Healthcare System in India

    1. Constitutional placement: Public health and hospitals are a State subject in the Seventh Schedule, with the Centre acting through centrally sponsored schemes and coordination rather than direct delivery.
    2. How delivery is organised: Rural care runs in three tiers, the sub centre, the primary health centre and the community health centre, with district hospitals and medical college hospitals above them.
    3. Where the disease burden now sits: Non communicable diseases account for around 66 per cent of total deaths, with cardiovascular disease and chronic respiratory disease the leading causes.
    4. Scale of the primary care network: More than 1,85,000 Ayushman Arogya Mandirs, formerly health and wellness centres, are operational.

    Government Initiatives for Public Healthcare

    1. National Health Mission: It is the umbrella programme funding rural and urban public health delivery through the states, and it created the Accredited Social Health Activist (ASHA) cadre in 2005.
    2. Pradhan Mantri Swasthya Suraksha Yojana: It addresses regional imbalance in tertiary care by setting up new AIIMS institutions and upgrading existing government medical colleges.
    3. Ayushman Bharat Digital Mission: It builds the digital health record layer, with Ayushman Bharat Health Accounts giving each person a portable health identifier.
    4. eSanjeevani: The national telemedicine service links primary health facilities to specialists on a hub and spoke model, extending specialist advice to remote and tribal areas.
    5. Pradhan Mantri Bhartiya Janaushadhi Pariyojana: Its Janaushadhi Kendras supply quality generic medicines at low prices, reducing the medicines share of household health spending.

    Back2Basics

    1. What it is: The Committee on Health and Family Welfare is one of the 24 department related standing committees of Parliament.
    2. Composition: Each such committee has 31 members, 21 from the Lok Sabha and 10 from the Rajya Sabha, all nominated rather than elected, for a tenure of one year.
    3. Origin: The system of 17 such committees was constituted with effect from 8 April 1993, and was restructured in July 2004 to the present 24.
    4. Weight of its reports: It examines the ministry’s demands for grants, bills and policy, and its recommendations are advisory rather than binding on the government.

    Matching Previous Year Question

    “[2024, GS2, 15 marks] In a crucial domain like the public healthcare system, the Indian State should play a vital role to contain the adverse impact of marketisation of the system. Suggest some measures through which the State can enhance the reach of public healthcare at the grassroots level.”

  • India has to act on its ‘sugar’ problem

    Why in the News

    The Food Safety and Standards Authority of India (FSSAI), the statutory food regulator, has proposed that packaged foods high in fat, salt or sugar carry a bold red warning on the front of the pack rather than in fine print on the back. The proposal follows prodding by the Supreme Court. It arrives against a childhood disease load that the World Obesity Atlas 2026 puts at 41 million overweight or obese Indians aged 5 to 19. The tension is that a warning label works on disclosure. The demand it targets is set by price, and India’s tax design currently charges a sugared drink and its zero sugar counterpart the same rate.

    What is the proposed front-of-pack warning label?

    1. What it marks: A bold red warning is placed on the front of a pack that is high in fat, salt or sugar, so the classification is visible at the point of choosing.
    2. What it replaces: The same information currently sits in the back of pack nutrition declaration, which is read after purchase rather than before it.
    3. What it is for: A person picking up instant noodles, a breakfast cereal or a health drink is told at a glance that the product is not as wholesome as its advertising claims.

    How large is the childhood problem?

    1. The headline count: 41 million Indian children and adolescents aged 5 to 19 are now overweight or obese.
    2. The clinical trend: The number of children presenting with morbid obesity and diabetes has climbed sharply within a few years.
    3. The driver is composition, not appetite: The rise is not only a matter of children eating more, it is a matter of what they are being sold.

    How is the market shaping what children eat?

    1. Products are sold as filling a dietary gap: Breakfast cereals, sweetened yoghurts and health drinks are marketed to parents as making up shortfalls in a child’s diet, emphasising energy and vitamins while saying little about sugar content.
    2. The same product is formulated differently by market: In 2024 a leading multinational was found adding sugar to infant food sold in India and other lower income countries, with sugar left out of the same product in Europe.
    3. Correction came from publicity, not regulation: A health drink popular in Indian homes turned out to be flavoured sugar syrup, and it took a social media storm rather than a regulator to force a 15 per cent cut in its added sugar.
    4. Unhealthy calories are priced to pocket money: An energy drink popular among teenagers is priced at Rs 20 and packs close to 17 grams of sugar, caffeine and artificial colour into a single bottle, and its label saying it is not meant for children stops nobody from buying it.
    5. Proximity to schools compounds it: Studies show that around schools and colleges the cheapest and most easily available snacks are also the least healthy.

    Where does the label stop short?

    1. School canteen norms are advisory: The FSSAI and the Central Board of Secondary Education (CBSE) have long recommended what schools should not sell, optional rules get treated as optional, and canteens stock whatever sells cheapest.
    2. The rule ends at organised retail: Most of India’s sugar, salt and trans fat is eaten unbranded from street stalls, dhabas and sweet shops, none of which is required to declare anything.
    3. The unregulated half of the plate is untouched: A red label on a biscuit packet does nothing about the jalebi sold loose beside it.
    4. Enforcement, not knowledge, is the missing input: A red warning label works only if it is actually enforced, and none of the underlying evidence about these products was ever secret.

    What does the United Kingdom’s levy show that India’s Goods and Services Tax slab does not?

    1. The United Kingdom taxed in tiers by sugar content: The soft drinks industry levy set thresholds by sugar concentration, so a manufacturer could lower its tax bill by changing the product.
    2. The response was reformulation, not repricing: Manufacturers reformulated their drinks to slip below the tax threshold rather than raise prices, and sugar consumption fell among both children and adults.
    3. India taxes the category, not the sugar: Since September 2025 aerated and sweetened beverages, sugar free versions included, have been folded into one 40 per cent Goods and Services Tax (GST) slab.
    4. The design removes the incentive it should create: A normal cola and its zero sugar counterpart pay the same tax, so a manufacturer has no reason to cut sugar.

    Does the objection that a sugar tax hits the poor hardest hold?

    1. The objection is not wrong: A consumption tax on a cheap product takes a larger share of a poorer household’s spending, and that is the standard case against it.
    2. It is only half the argument: Unregulated cheap sugar already extracts a heavy price from the poor, who bear the brunt of the diabetes, hypertension and childhood obesity that sugar heavy diets drive, with the least means to treat it.
    3. Inaction is itself a charge: Doing nothing is not neutral, it is a slower and costlier tax paid in ill health rather than in rupees at the till.
    4. The design answers the objection: A tax calibrated to sugar content nudges reformulation, and part of the revenue set aside to make healthy food cheaper offsets the burden on the households least able to absorb it.

    Challenges to the front-of-pack warning label

    1. A binary threshold invites formulation just below the line: A single high in fat, salt or sugar cut off rewards a product that sits marginally under it as much as one that is genuinely reformulated. Eg. The United Kingdom’s tiered levy was designed precisely to reward movement between bands rather than a single pass or fail.
      The Fix: Publish the underlying nutrient values on the front of the pack alongside the warning, so the distance from the threshold is visible rather than collapsed into one mark.
    2. Loose and cooked food carries no declaration duty: The disclosure obligation attaches to a package, so the food sold without one falls outside the rule entirely. Eg. Sweet shops, dhabas and street stalls supply a large share of India’s added sugar and declare nothing.
      The Fix: Extend a simplified menu board declaration to registered food service outlets above a turnover threshold, starting with chains that already standardise recipes.
    3. Advisory school norms carry no consequence: A recommendation to schools on what not to sell creates no liability for a canteen that ignores it. Eg. FSSAI and CBSE guidance on school canteens has stood for years without changing what canteens stock.
      The Fix: Make the school canteen standards a condition of affiliation, so non compliance is enforced by the board that already inspects the school.
    4. Marketing to children is not restricted alongside the label: A warning on the pack competes with advertising that positions the same product as a nutritional supplement for a growing child. Eg. Health drinks and sweetened cereals are advertised to parents on energy and vitamin content.
      The Fix: Set enforceable limits on the promotion of products carrying the warning mark to audiences under eighteen, rather than relying on industry self regulation.

    Conclusion

    A warning label changes what a buyer knows and leaves untouched what a buyer pays. The regulator is correcting a disclosure failure, and the tax code is holding the composition incentive flat; the two are pulling against each other inside the same policy. What has to change is the tax base: calibrating the levy to sugar content is what turns a consumer nudge into a producer obligation, and the label alone will not do it. The markers to watch are whether the labelling regulation is notified as mandatory rather than advisory, and whether the single beverage slab is broken into sugar linked tiers.

    Non-Communicable Diseases in India

    1. What they are: Non communicable diseases are long duration conditions such as cardiovascular disease, diabetes, cancer and chronic respiratory illness, driven by diet, tobacco, alcohol and physical inactivity rather than by infection.
    2. Their share of mortality: They account for about 66 per cent of total deaths in India, with cardiovascular diseases at 28 per cent and chronic respiratory diseases at 12 per cent.
    3. The scale and the age profile: An estimated 6.1 million Indians die of a non communicable disease each year, and roughly one in four Indians faces the risk of dying from one before the age of 70.
    4. The economic cost: India is projected to lose 4.58 trillion dollars by 2030 to non communicable diseases and mental health disorders.

    Laws and Rules Governing Non-Communicable Disease Prevention

    1. Food Safety and Standards Act, 2006: It replaced the Prevention of Food Adulteration Act, 1954 and created a single regulator for food standards, labelling and safety across the food chain.
    2. Food Safety and Standards (Labelling and Display) Regulations, 2020: They set the mandatory nutrition declaration and per serve information that the front of pack proposal is built on top of.
    3. Cigarettes and Other Tobacco Products Act, 2003: It bans advertising, restricts sale to minors and mandates pictorial health warnings, and it is the domestic precedent for a graphic warning driving consumption behaviour.

    Government Initiatives for Non-Communicable Disease Prevention

    1. Eat Right India: An FSSAI campaign to promote safe, healthy and sustainable food, working through certification of workplaces, campuses and eateries.
    2. National Programme for Prevention and Control of Non-Communicable Diseases: It funds population level screening for hypertension, diabetes and common cancers through district and community health centres.
    3. Fit India Movement and POSHAN Abhiyaan: The first targets physical inactivity through schools and workplaces, the second targets undernutrition and anaemia in children and mothers.

    Challenges in Non-Communicable Disease Prevention

    1. Surveillance is event based rather than predictive: Data for communicable disease, non communicable disease and animal health is collected in separate vertical silos, so a risk trend is visible only after it becomes a caseload. Eg. Childhood obesity data reaches policy through a periodic survey rather than a continuous registry.
      The Fix: Merge the vertical disease reporting streams into a single district level dashboard with a fixed reporting cycle.
    2. Primary care cannot sustain lifelong treatment: A non communicable disease requires uninterrupted medication, and the network closest to the patient is the least reliably supplied. Eg. Only 60 per cent of Ayushman Arogya Mandirs reported a dependable supply of essential non communicable disease drugs.
      The Fix: Tie the facility’s drug budget to its registered patient load rather than to a flat allocation, so supply scales with the panel it serves.
    3. Three disease burdens compete for the same budget: India simultaneously carries infectious disease, rising non communicable disease and emerging zoonotic threats, and health spending is allocated against outbreaks first. Eg. Prevention programmes are routinely reprioritised when an epidemic draws staff and funds.
      The Fix: Ring fence a fixed share of the health budget for prevention that cannot be reallocated to outbreak response within the year.
    4. Fiscal tools are used on tobacco but not on diet: Higher taxation is accepted as a public health instrument for tobacco and is treated as a revenue question for sugar and salt. Eg. India’s beverage taxation was reorganised in September 2025 without any sugar content differential.
      The Fix: Earmark a defined share of any diet related levy for subsidising fruit, vegetables and pulses, so the instrument is visibly a health measure rather than a revenue measure.

    Matching Previous Year Question

    “[2018] Consider the following statements: 1. The Food Safety and Standards Act, 2006 replaced the Prevention of Food Adulteration Act, 1954. 2. The Food Safety and Standard Authority of India (FSSAI) is under the charge of Director General of Health Services in the Union Ministry of Health and Family Welfare. Which of the statements given above is/are correct? (a) 1 only (b) 2 only (c) Both 1 and 2 (d) Neither 1 nor 2 ANSWER: (a)”

  • Govt. not in favour of treating English as ‘native’ language

    Why in the News

    The Union government has told the Supreme Court that it “has an issue” with treating English as an indigenous language. It has assured the court that it will move quickly on consultations to grant the current Class 6 batch a one-time reprieve from the mandatory third-language paper in the Central Board of Secondary Education (CBSE) Class 10 examination. The court had earlier asked the CBSE to consider that relief. The petitioners want English moved out of the indigenous category into the “non-native” or foreign language category, and the Centre has reserved its submissions on that question. The court has also issued notice on petitions filed by minority schools on the three-language scheme. The dispute is about classification rather than count, because what counts as an indigenous language decides how many Indian languages a student must carry.

    What is the three-language formula under the National Education Policy, 2020?

    1. What it requires: The National Education Policy, 2020 continues the three-language formula in school education. At least two of the three languages taught must be native to India.
    2. Why classification decides the burden: A language treated as indigenous can fill one of the two mandatory Indian-language slots. English placed outside that category cannot, so a student carries an additional Indian language alongside it.
    3. Choice rests with States and students: The policy states that no language will be imposed on any State. The three languages are chosen by States, regions and students themselves.

    What has the Centre now told the Supreme Court?

    1. The petitioners’ ask: Counsel for the petitioners sought an order shifting English into the “non-native” or foreign language category.
    2. The Centre’s objection: The Centre said it “has an issue” with that, and asked to make its submissions before any order is passed.
    3. The assurance on the reprieve: The Centre told a Bench headed by the Chief Justice of India that a meeting with the officials concerned would be arranged within a day or two to decide on the one-time reprieve for Class 6 students.

    Why does the current Class 6 batch sit at the centre of the case?

    1. One batch faces full implementation: Under the CBSE guidelines, students in Classes 7 to 9 were exempted from the third-language requirement. The current Class 6 batch was slated for full implementation of the scheme.
    2. The examination date: Full implementation carries a mandatory Class 10 Board examination in the third language by 2031.
    3. The court’s earlier direction: At an earlier hearing the court asked the CBSE to consider relieving Class 6 students of writing the third-language examination in Class 10.
    4. The Bench on sequencing: A judge on the Bench said time is needed for students and for infrastructure to reach parity across education boards. Starting with the mother tongue, then an indigenous language, then another indigenous or foreign language works only where it begins in a lower class.

    What else is now before the court?

    1. The minority schools’ challenge: The court issued notice to the government on petitions filed by minority schools on the implementation of the three-language scheme.
    2. The English question is undecided: No order was passed on shifting English out of the indigenous category, because the Centre asked to be heard on it first.
    3. Timeline pressure from the petitioners: Counsel for the petitioners said parents were anxious and urged the court against further adjournments. The hearing stands adjourned to 17 September.

    Challenges to the three-language formula

    1. Political resistance where the formula reads as imposition: A centrally set language requirement collides with State language policy. Eg. Tamil Nadu has followed a two-language policy of Tamil and English since 1968, after the anti-Hindi agitations of 1965, and has refused the three-language formula since.
      The Fix: Make the third language a State-notified choice, and tie central funding to teacher recruitment for whichever language a State selects rather than to adoption of the formula itself.
    2. Teacher availability limits real choice: A school cannot offer a language for which no trained teacher is posted. Eg. UDISE+ returns record over one lakh single-teacher schools in the country.
      The Fix: Sanction language-specific posts and permit a shared language teacher across a cluster of schools before the subject becomes examinable.
    3. Foundational reading is the prior constraint: A third language added at the middle stage assumes reading fluency that many students do not have. Eg. The ASER 2024 survey found under half of Class 5 students in rural India able to read a Class 2 level text.
      The Fix: Sequence the third language behind a measured foundational literacy benchmark in the mother tongue, rather than behind a fixed grade.
    4. Minority institutions’ autonomy is engaged: Article 30(1) gives minorities the right to establish and administer educational institutions of their choice, and a prescribed set of languages touches that right. Eg. In T.M.A. Pai Foundation v. State of Karnataka (2002), an eleven-judge Constitution Bench held that regulation of such institutions is permissible for standards and not for control of administration.
      The Fix: Frame the language requirement as an attainment standard rather than as a prescribed language set, so minority institutions retain the choice of which languages meet it.

    Conclusion

    The case turns on a classification question rather than on the number of languages taught. Whether English is treated as indigenous decides whether a student carries two Indian languages or three. The Centre has reserved its position on that and has offered relief only to one batch of students. What remains unresolved is what happens to every batch that follows it.

    Matching Previous Year Question

    “[2020, GS2, 15.0 marks] National Education Policy 2020 is in conformity with the Sustainable Development Goal-4 (2030). It intends to restructure and reorient education system in India. Critically examine the statement.”

  • Reclaiming universities through trust, student voice

    Why in the News

    The Supreme Court has stayed the Bar Council of India (BCI)’s order against the graduating batch of the National Academy of Legal Studies and Research (NALSAR), Hyderabad. The same intervention quashed all first information reports (FIRs) against the protesting students. It declared that the BCI has no disciplinary control over students. It also reduced the three year practice condition for writing the judicial services examination to one year. The order follows a protest by law students seeking a say in their own convocation, widely attributed to an oral remark by the Chief Justice of India that was quickly clarified. The contest is over whether campus unrest is a failure of student discipline or a failure of a governance model that leaves students out of the decisions binding them.

    What is academic freedom?

    1. The freedom to teach, research and question: Academic freedom is the entitlement of those engaged in scholarly teaching and research to decide what to study, what to teach and what to challenge, without direction from the government or the university administration.
    2. No express Indian guarantee: The Constitution of India does not mention academic freedom. Article 5(3) of the German Basic Law guarantees scientific freedom (Wissenschaftsfreiheit) as a right of everyone engaged in scholarly teaching and research.
    3. A recognised right elsewhere: The Constitutions of Japan, South Africa, Portugal and Spain contain a comparable freedom. Article 137 of the Basic Law of Hong Kong provides that educational institutions may retain autonomy and enjoy academic freedom.
    4. Its limit is conduct, not speech: The freedom carries no right to defame or to engage in anti-national activity. Where an academic activity involves conduct rather than speech, the state is entitled to regulate that conduct.

    Why is curriculum the sharp edge of the dispute?

    1. Curriculum is set without the people it binds: University curriculum should be decided by the stakeholders, including students. Eg. Delhi University dropped a paper on the Delhi Sultanate along with some other papers.
    2. Students read such changes as political: Curriculum changes of this kind are seen as having ideological reasons rather than academic ones, which turns an academic decision into a governance grievance.
    3. The direction of restraint runs both ways: Government is not to dictate to universities what to teach, how to teach and what not to teach. Universities owe the same freedom to their departments and faculties.
    4. The campus exists for the contested question: Universities are meant to be a special place for reflection, inquiry and discussion, which is the function a closed curriculum process removes.

    What do experiences abroad show about academic freedom under pressure?

    1. The United States has used funding as leverage: Federal funding has been weaponised to reshape campus culture. Diversity programmes have been dismantled and research funding in areas such as climate change has been reduced.
    2. Permitting protest has itself invited pressure: Universities have faced pressure for allowing student protests, including those over Gaza.
    3. Neither ideological side is exempt: Right wing and left wing regimes have both, at times, sought to control universities.
    4. The pattern is old: Arnold Toynbee resigned from King’s College London in 1924 over his writings on the Greek army’s atrocities. Professors were persecuted during the McCarthy era.
    5. Funders now shape the research agenda: Declining public funding has left research agendas increasingly influenced by funders, corporations and pharmaceutical companies.

    What is the control model of university governance?

    1. Authority sits in one office: Most universities remain Vice-Chancellor centric. Students, who are the reason universities exist, have little say in their governance.
    2. Grievances have no route upward: Vice-Chancellors rarely hold open houses and are often inaccessible to ordinary students. Unaddressed grievances leave students feeling ignored, and some then take extreme steps.
    3. Control substitutes for dialogue: Administrations adopted the control model as governments increasingly sought to control universities. A community of highly educated faculty and young people requires dialogue, trust and openness rather than surveillance.
    4. Knowledge creation needs the opposite conditions: Universities exist to innovate and create knowledge, which requires the freedom to question everything and challenge existing ideas.

    How does under-investment compound the control problem?

    1. The policy target has not been met: The National Education Policy 2020 promises public investment of 6 per cent of Gross Domestic Product (GDP) in education. Public investment has steadily declined and hovers around 4 to 4.1 per cent.
    2. Higher education gets the smallest share: Within that spending, higher education receives the smallest allocation, so the system is over-regulated and grossly underfunded at the same time.
    3. Autonomy is not alien to the system: The ancient Gurukul system was entirely autonomous, and the present arrangement regulates far more and funds far less.
    4. The shortfall is visible on campus: Public university infrastructure has deteriorated and hostels are in acute shortage, which produced the recent deaths in New Delhi. Faculty positions remain vacant and guest faculty are poorly paid.
    5. Teaching and examinations both fail the student: Poor teaching frustrates students. Repeated examination paper leaks add to their stress.

    What do Vice-Chancellor appointments reveal?

    1. Natural justice is overlooked: In one case a Vice-Chancellor changed the composition of the selection committee, chaired it and voted in the selection of his wife. She was appointed as Vice-Chancellor.
    2. The courts did not correct it: The judiciary declined to follow its own precedents of quashing such appointments.
    3. An adverse record is not a bar: Individuals with questionable records and adverse Central Vigilance Commission (CVC) reports have been appointed, and some State universities face allegations of bribery.
    4. Recruitment rewards leaning over merit: Faculty recruitment over-emphasises ideological leanings rather than merit. Ideological governments may prefer candidates with particular leanings, and merit should not be completely undermined on that account.
    5. Examination integrity follows appointment integrity: No examination system can be foolproof where paper setters, moderators or testing officials are appointed for reasons other than absolute merit and integrity.

    Who actually absorbs the blame for campus unrest?

    1. The anger travels past the administration: Student frustration erupts against the government rather than against university administrations. The government received the criticism for the actions of the Vice-Chancellor in the appointment case.
    2. Much of it is avoidable on campus: The backlash could largely be avoided where administrations engage students in meaningful dialogue and provide timely relief.
    3. The government is not a bystander either: Administrations adopted the control model because governments sought control of universities, so the incentive that produced the model is a governmental one.

    What does the liberty model change?

    1. Trust is the operative mechanism: The liberty model of governance was implemented across three universities over 16 years. Students who are trusted act more responsibly in turn.
    2. Access without gatekeeping: Students met the Vice-Chancellor without appointments and raised personal concerns and difficulties. That access made frank conversations possible when difficult or unpopular decisions had to be taken.
    3. Unpopular ideas are protected: The model treats the university as a space where even the most unpopular ideas can be freely debated, which is the opposite of the top-down model.
    4. Students sit inside the decisions: Students are given a meaningful role in academic, administrative and financial decisions, including faculty appointments, procurement, curriculum design and the drafting of university regulations.
    5. A statutory precedent already exists: Students at Aligarh Muslim University have a statutory role in selecting the Vice-Chancellor.

    Challenges to the liberty model of university governance

    1. Participation rights can be captured by party politics: Campus unions aligned to national parties can convert a participation right into a channel for external political control. Eg. Delhi University Students’ Union elections are contested by the student wings of national parties.
      The Fix: Tie student participation to reserved seats on academic and finance bodies with fixed terms, so it runs through statutory channels rather than street mobilisation.
    2. A Vice-Chancellor cannot devolve powers that are not his: Faculty appointments and university finances are governed by University Grants Commission (UGC) regulations and State legislation, so student participation in them rests on the incumbent’s discretion. Eg. The Vice-Chancellor is himself selected by the Chancellor or Visitor from a search committee panel.
      The Fix: Amend university statutes to create student membership on selection and finance committees, so participation has a legal basis rather than a personal one.
    3. The model lapses with the person who ran it: A governance style adopted by one Vice-Chancellor ends when that office changes hands, since nothing in the statute compels a successor to continue it. Eg. Open house access is an administrative practice and not a rule.
      The Fix: Write grievance redressal timelines and open house frequency into university ordinances so the practice survives a change of office.
    4. Trust cannot supply what money supplies: Dialogue does not create hostel seats, permanent faculty or laboratory funding, which are the material grounds of much campus unrest. Eg. Sanctioned faculty posts in central and State universities stay vacant regardless of the governance style adopted.
      The Fix: Link central grants to filled sanctioned posts and audited hostel capacity, so funding follows the deficits that generate protest.

    Conclusion

    The Supreme Court’s order settles who may discipline a law student. It does not settle who governs a campus. Curriculum decisions, convocation arrangements and appointments all turn on whether students hold any formal seat in university decision making, and at present they hold almost none. The measure worth watching is whether university statutes are amended to give students standing on academic and selection bodies, since a governance practice resting on the person in office leaves with that person.

    Higher Education in India

    1. Second largest system in the world: Total enrolment is estimated at 4.65 crore in 2026, up from 3.42 crore in 2014-15.
    2. Institutional spread: India hosts over 1,168 universities and 45,473 colleges, against 760 universities in 2014-15.
    3. Participation is short of the target: The Gross Enrolment Ratio in higher education, meaning enrolment at that stage as a share of the population in the corresponding age group, stands at 28.4 per cent against the National Education Policy 2020 target of 50 per cent by 2035.
    4. Women now enrol marginally more than men: The Gender Parity Index stands at 1.01, indicating slightly higher female than male participation for the first time.

    Constitutional Framework Governing Higher Education

    1. Entry 25, List III: Education, including technical and medical education and universities, is a Concurrent List subject after the Constitution (Forty-second Amendment) Act, 1976.
    2. Entry 66, List I: Coordination and determination of standards in institutions of higher education and research is reserved to the Union.
    3. Entry 63, List I: Banaras Hindu University, Aligarh Muslim University and Delhi University are institutions of national importance under Union competence, along with any other so declared by Parliament.
    4. Article 30(1): Religious and linguistic minorities have the right to establish and administer educational institutions of their choice.
    5. Article 19(1)(a): Free speech on campus is protected, subject only to the restrictions Article 19(2) itself permits.

    Laws and Rules Governing Higher Education

    1. University Grants Commission Act, 1956: Establishes the UGC to coordinate and determine standards in university education and to disburse grants to universities and colleges.
    2. All India Council for Technical Education Act, 1987: Creates the statutory regulator for technical education, covering planning, norms and approval of technical institutions.
    3. National Council for Teacher Education Act, 1993: Creates the regulator for teacher education programmes and the institutions that run them.
    4. Anusandhan National Research Foundation Act, 2023: Establishes the National Research Foundation to seed and fund research across higher educational institutions, including State universities.

    Government Initiatives for Higher Education

    1. National Education Policy 2020: Replaces the National Policy on Education, 1986, and is built on access, equity, quality, affordability and accountability.
    2. Academic Bank of Credits: A digital repository holding course credits, which enables multiple entry and exit within a degree programme.
    3. Automated Permanent Academic Account Registry (APAAR): A single student identifier linking academic records, skills and transfers in one portal.
    4. Prime Minister’s Research Fellowship: Doctoral fellowships for research scholars, expanded to award 10,000 new fellowships.

    Challenges in Higher Education Governance

    1. Fragmented regulatory structure: Multiple bodies issue overlapping and sometimes conflicting guidelines to the same institution, which delays academic decisions. Eg. A technical department inside a university answers to the All India Council for Technical Education and the UGC at the same time.
      The Fix: Consolidate approvals under a single higher education regulator with separate verticals for funding, standard setting and accreditation.
    2. Quality is unmeasured across much of the system: Over 30 per cent of Indian higher educational institutions remain unaccredited as of early 2026. Eg. Accreditation by the National Assessment and Accreditation Council is not a precondition for most colleges to award degrees.
      The Fix: Make one completed accreditation cycle a condition for degree granting status and for central grants.
    3. Research spending is stagnant: Research and development expenditure stands at 0.64 per cent of GDP, against about 2.4 per cent in China and 3.4 per cent in the United States. Eg. India contributes under 5 per cent of global research publications.
      The Fix: Route National Research Foundation funding towards State universities, which carry most enrolment and almost none of the research grant.
    4. Employability does not follow the degree: Curricula are not aligned to hiring requirements, so enrolment growth does not convert into work. Eg. Only about 4 per cent of higher education carries formal skill training.
      The Fix: Embed apprenticeship credits inside degree programmes under the National Credit Framework.

    Back2Basics: Bar Council of India

    1. A statutory body under the Advocates Act, 1961: It regulates the legal profession and legal education in India.
    2. Standard setting: It lays down standards of professional conduct and etiquette for advocates, and prescribes the conditions on which a law degree is recognised for enrolment.
    3. Composition: Its members are elected by the State Bar Councils, with the Attorney General of India and the Solicitor General of India as ex officio members.

    Matching Previous Year Question

    “[2014, GS2, 12.5 marks] Should the premier institutes like IITs/IIMs be allowed to retain premier status, allowed more academic independence in designing courses and also decide mode/criteria of selection of students. Discuss in light of the growing challenges.”