Here are five significant developments over the past year that raise concerns about the state of health and nutrition in India.

Newborns charred to death in hospitals

At-least 12 newborn babies were charred to death in the newborn care unit of Maharani Laxmi Bai Medical College Hospital at Jhansi last month. According to the newspapers, the neonatal unit had only 19 beds but was three times over-occupied, with many incubators or radiant warmers having three babies each.

Parents of the babies reported that provisions to douse the fire in the nursery were inadequate.

This was not an isolated event this year: in May, a fire broke out in a private hospital in East Delhi in which at least seven babies were burnt to death and many others injured. It was later found that the neonatal facility had flouted several fire safety norms, including keeping extra oxygen cylinders on the premises. The hospital’s owner was later arrested.

These incidents were widely covered in national and international press. While the state government did announce monetary compensation to the families, there was not statement or plan of action issued on preventing such accidents.

Shortage of anti-tubercular drugs

The shortage of anti-tubercular drugs that started late last year became even more acute this year. A delay in issuing the tenders, and high prices quoted by vendors were some of the reasons given for this shortage. In many states, the treatment of thousands of patients was interrupted.

In the absence of any systematic studies, the impact of shortage of drugs on patients getting cured of the disease, on the transmission of the disease and on the increase in drug resistance can only be guessed. But is likely to be enormous.

Coming on heels of the Covid pandemic when TB treatment was severely interrupted, this can only mean catastrophe for control of the disease in India. Instead of acting on the news of shortage by the media, the government denied the shortage.

The only good news in this year about TB was an increase in cash transfers for patients from Rs 500 to Rs 1,000. If this cash transfer is made timely, it may help the TB patients to consume nutritious food during the treatment.

Persistence and upsurge of malaria

The World Malaria Report 2024, based on data from the year 2023, reports that India accounted for 50% of all malaria cases and, with Indonesia, 88% of all malaria deaths in the South East Asia region. Despite political instability, Sri Lanka managed to eliminate malaria some years ago, and countries such as Bhutan and Timor Leste have reported zero malaria deaths for about ten years now.

The report did mention that as compared to 2022, the number of estimated cases of malaria in India declined by about 9%.

However, in 2024, there has been news of outbreaks of malaria across the forested areas of central and eastern India: in Chattisgarh, Jharkhand and Odisha. There were also outbreaks of malaria among tribal communities of South Rajasthan in Udaipur region.

Heavy and erratic rainfalls in many of these regions due to climate change also resulted in prolonged occurrence of malaria in these regions.

Mass bungling in health programme

In November this year, two patients died due to unnecessary angioplasty procedures in a private hospital in Ahmedabad. Investigations revealed that the hospital had been conducting unnecessary procedures on many more patients to claim money from the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana national health insurance scheme.

Further investigations led to the unearthing of a systematic fraud involving a private communication firm that was contracted to issue cards under the scheme. Nearly 3,000 such fraudulent cards were issued to ineligible individuals using tampered credentials. Since its inception, more than three lakh financial frauds have been detected under the scheme, and more than 56,000 unnecessary surgeries have been conducted.

This incident highlights the potential of not only wide-scale financial fraud, but also of deaths of insured people due to unnecessary and harmful procedures. It highlight an urgent need to relook at India’s investments in state-funded health insurance, and safety mechanisms to prevent fraud, misuse, denial and harm.

Stagnant union health budget

The National Health Policy of India in 2017 committed to raising government expenditure on health from 1.15% then to 2.5% of GDP by 2025. Successive budgets since then failed to meet this commitment, and the government expenditure continued to hover around 1%.

The Union Health Budget of 2024 also failed to live up to this expectation. The mere increase of allocation by 9% from revised estimates of the previous year is barely sufficient to meet the inflation.

With the persistent high prevalence of diseases such as malaria and TB, the growing burden of chronic diseases such as chronic lung diseases, heart disease and diabetes, and the threat of emerging disease (of which Covid was the most alarming), stagnant budgets do not augur well for future of healthcare in India.

Pavitra Mohan is a pediatrician and co-founder of Basic Health Care Services, which provides low cost healthcare in rural, high migration areas of South Rajasthan.