Healthcare infra needs major boost, says health secretary
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Ranchi: The state is grappling with a severe shortfall in
healthcare infrastructure
, with a significant gap in the availability of hospital beds across the state, additional chief secretary, Ajoy Kumar Singh, said at a workshop.
"While the state currently has around 31,000 hospital beds in both govt and private sectors, it falls short by over 82,000 beds based on World Health Organization (WHO) norms, which recommend at least 1,13,000 beds for the population," he added.
"The current figure stands far below the requirement, raising concerns about the state's preparedness to handle medical emergencies, especially during disease outbreaks or natural disasters," said Singh.
Singh stressed the urgent need for sustained investment and strategic planning to strengthen healthcare delivery, particularly in underserved and rural areas. He called for better coordination between the health department and hospitals, especially those implementing govt health schemes.
Health minister Irfan Ansari
, addressing the gathering, reaffirmed the govt's commitment to improving healthcare access. "We are ready to provide quality treatment to the people of state. The state will appoint the best doctors, and we are working to upgrade institutions like Rims with AI-based technologies," said Ansari.
He also expressed concern over reports of private hospitals discontinuing treatment once govt scheme funds are exhausted. Ansari said, "Such behaviour is inhuman. Hospitals must take full responsibility for critical patients."
The minister also assured that a separate workshop will be held for private hospitals that couldn't attend the event. Ansari, said, "I am also a doctor. If there is any issue, speak to me directly. We want the system to function smoothly. The health department plans to address the bed shortage by upgrading community health centres, expanding district hospitals, and encouraging public-private partnerships."
The workshop focused on improving implementation of the
Ayushman Bharat
and Abua Health Security schemes to ensure financial protection and wider healthcare access. Officials stressed that while affordability is addressed through schemes, physical access to beds, equipment, and trained personnel remains a pressing challenge.
Executive director of State Arogya Society, Abu Imran, urged all private hospitals to follow scheme guidelines. "Many small hospitals lack trained staff and struggle to interpret scheme protocols. We need to ensure they receive right training and support," he said, also emphasising the need to enrol more hospitals under other health insurance initiatives like the Rajyakarmi Swasthya Bima Yojana and Vaya Vandan Yojana.
The event was attended by civil surgeons from across districts, representatives of small hospitals from both rural and urban areas, and officials of the State Arogya Society. Training sessions on hospital capacity, grievance redressal, and scheme guidelines were also conducted during the programme.
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Economic Times
2 hours ago
- Economic Times
One cough too many: India's TB fight isn't quite there yet
Agencies A PIB release dated March 24, 2025, says India's TB elimination targets for 2025 are an 80% reduction in incidence and a 90% reduction in deaths, compared with 2015. One moment Anushka (name changed) was a college student. Then her world turned upside down. It started with a persistent cough and high fever. Despite popping meds, it wouldn't go away. Tests followed and then came the news that knocked the stuffing out of her—she had a fatal form of tuberculosis (TB). With scarred lungs, she gasped for each breath. The bacteria had killed her appetite, making her frail and bony. Her skin colour changed—to dark and then grew paler. At 20, her life expectancy dwindled to a few months.'I felt weak,' she recalls, 'and preferred to be alone.'Battling extensively drug-resistant tuberculosis or XDR-TB, a form of the disease in which drugs rarely worked, Anushka's only option was to be loaded each day with scores of tablets and injections. Those came with toxic side effects. For over four years, she moved between government and private hospitals, enduring cycles of failed treatment. Relief came only when she was placed on a salvage regimen—the last option when all other interventions are exhausted—at a Médecins Sans Frontières (MSF) clinic in Govandi, Mumbai. The global humanitarian group offered Anushka a cocktail of bedaquiline, delamanid and imipenem injections, a set of very powerful meds often inaccessible to most Indians due to supply restrictions aimed at curbing drug resistance. Anushka, who has now recovered, recounted her ordeal at MSF's TB Day event in Mumbai on May 12, speaking before an audience of doctors, a quiet smile breaking through years of pain. Her journey to recovery is rare, and alien to millions in India, which reflects a public health system still failing its most vulnerable. India now accounts for more than a quarter of all TB cases reported worldwide. In 2023, the country had 26% of the global TB burden, according to the World Health Organization (WHO). Bending the curve remains difficult despite multiple national programmes. How can India improve?In 2018, when India pledged to eliminate TB by 2025, five years ahead of the set global target, the objective was clear. And progress has been made, too. Between 2015 and 2023, TB incidence (new and relapsed cases per 1 lakh population every year) fell by 18% and deaths by 24%, per is a sign in the right direction, but the number of cases are still astounding, especially when it comes to drug-resistant variants. 'India bears the highest burden of XDR-TB globally, with an estimated 110,000 new cases annually,' says Professor Anil Koul of the London School of Hygiene and Tropical Medicine. A key figure in TB drug research, Koul was part of a Johnson & Johnson team that developed bedaquiline, one of the most effective drugs against resistant TB notes that Covid-19 deepened the crisis, and underfunded research has stalled progress. Of the 27 drugs in clinical trials, none have reached Phase III. Bedaquiline remains the mainstay.A 100-day TB Elimination Challenge was launched by the government in December 2024 to amplify efforts to diagnose and treat TB at the village level, but experts aren't satisfied.'We are not on track,' says Dr Animesh Sinha, chronic care and infectious disease advisor, MSF. 'To meet the 2025 milestones of WHO's End TB strategy, India should achieve a 50% reduction in TB incidence rate and a 75% reduction in the total number of TB deaths compared with 2015.' Although numbers have fallen, the quantum has been woefully short of the target, as WHO numbers suggest.A PIB release dated March 24, 2025, says India's TB elimination targets for 2025 are an 80% reduction in incidence and a 90% reduction in deaths, compared with 2015.A key problem is underreporting emanating from under-diagnosis. India's notification rate (number of TB cases diagnosed and officially reported) has improved from 108 per 100,000 population in 2010 to 166 in 2023, yet many cases, especially in rural areas, go undetected.'In order to address the TB crisis, we have to find the missing cases,' says Sinha. Nonetheless, the 2025 goal helped push TB up the political agenda. Ni-kshay, a digital platform for notification and treatment monitoring, is improving reporting. But without proportionate investment in diagnostics, staffing and drug access, the pace of progress will be inconsistent. Intermittent drug shortages have been reported, and India spent just 2.1% of the National Tuberculosis Elimination Programme budget on diagnostics till 2023-24, an IndiaSpend RTI revealed. 'The 2025 target was always a stretch,' says Koul. 'But it did galvanise government machinery, leading to faster approvals for newer regimens like bedaquiline, speedier rollout across TB centres and more budgetary support, including for nutritional aid.'That said, TB continues to receive only a sliver of public health funding. But even so, he notes, there certainly is a positive trend in fighting back, considering the complexity of the disease and the socioeconomic factors shaping in an ET Morning Brief podcast in January, Dr Urvashi Singh, deputy director-general (TB), Ministry of Health and Family Welfare, said, 'The domestic budget for the national TB programme has increased over five times in the last 10 years.' India, she added, is the only high-burden country where 91% of the programme is backed by domestic detection is often the difference between quick recovery and years of suffering. Goa-based diagnostic device maker Molbio Diagnostics' Truenat, a portable molecular-testing platform, introduced in 2017, expanded diagnostic access, particularly in low-access regions. 'We supplied over 90 lakh testing kits last year and expect to provide 1.25 crore this year,' says Sriram Natarajan, CEO of Molbio, which is working with government and statelevel partners to rollout molecular testing.A Truenat test costs just Rs 640, a fraction of what imported diagnostics demand, says Natarajan. In public health, he argues, the real measure isn't price, but cost-effectiveness, especially when early detection can avert far greater globally approved diagnostics protocols remain out of reach in India. The WHO-recommended urine TBLAM test, used to diagnose TB in HIVpositive patients, is still unavailable in the country, despite successful validation studies in Mumbai in 2022. Registration barriers and lack of supply from manufacturers have led to lack of access, says Leena Menghaney, a public health lawyer based in Delhi. Supplyrelated issues could be because trials in India have yet to conclude, according to industry delays cost precious lives. Late detection risks high transmission rates and complications for patients. Dr Jennifer Furin, infectious diseases clinician, Harvard Medical School, says while Truenat is helpful and the diagnostic pipeline is robust, the outdated and slow systems for approving novel tools in India have a detrimental impact. Furin points to a critical gap: the lack of household-level prevention. Studies, including a 2023 trial published in TheLancet, show that modest nutritional support for families of TB patients can sharply reduce transmission. Another model, published in TheLancet this year, estimates that improving household nutrition alone could prevent nearly 5% of TB deaths by carrying the world's highest TB burden, regulatory reforms have been slow in India. Some gains have been made, but systemic delays continue to blunt the impact of new patients with drug-resistant TB, a new wave of treatment offers hope, but conditions apply. Regimens like a six-month, all-oral combination termed BPaLM— bedaquiline, pretomanid, linezolid and moxifloxacin—have been game-changers, replacing the gruelling 24-month regimens of daily injections and pills. 'These regimens are better tolerated and highly effective, with about 90% of people completing treatment successfully,' says Sinha. While clinicians welcome the government's push for shorter regimens, access remains limited—only 1,700 patients in India have received them, according to Dr Rupak Singla, head of the department of respiratory medicine, National Institute of Tuberculosis and Respiratory Diseases, Delhi, who spoke at the event in Mumbai. Adoption has lagged due to limited access to drug susceptibility testing for newer drugs, which is crucial for choosing an appropriate treatment strategy. The BPaLM regimen can't be given in cases where more than one organ system is involved or in patients with severe extrapulmonary disease, 'both of which are common in India,' according to Dr Alpa Dalal, head of unit, Group of TB Hospitals, Sewri, Mumbai. BPaLM should not be prescribed for patients previously treated with bedaquiline, says Dalal, unless drug susceptibility to bedaquiline and linezolid is says even in extensive pulmonary TB, where studies have shown good outcomes with BPaLM, many clinicians are cautious. In longer regimens, patients with extensive lung involvement have had higher relapse rates, compared with patients with limited disease, she explains, and that concern carries over. A study published in OUP's research platform, Oxford Academic, in March 2025 shows that bedaquiline resistance among previously treated patients can reduce the drug's warn that such resistance could undercut its effectiveness in the long term if not addressed early. But Koul says, 'Bedaquiline has galvanised TB R&D. It will remain a core component of future regimens, unless we see a dramatic rise in resistance in clinical practice.'The economics of care create barriers too. Pricing is a big hurdle. Regimens with imipenem cost thousands of rupees per day. Anushka was treated free by MSF. Else each injection alone, she said, would cost Rs 2,499. Considering the socioeconomic realities of India, perhaps this is where the government could step approach to procurement is problematic too. The country selectively joins pooled procurement platforms like the Global Drug Facility, which could reduce costs. 'India has in the past refused to participate in this, unless they had an emergency,' says policy and procurement, TB is a profoundly social disease, shaped by stigma, poverty and undernutrition. Even the best drugs won't work if care doesn't reach those who need it most. Guidelines may improve and approvals may accelerate but until the system meets people where they are, too many will be left suffered for years before she got cured. Her strength wasn't just in surviving; it was in refusing to give up. 'Even in that condition, I completed my graduation and kept chasing my dreams,' she says. India's TB response must now rise to match that grit, with urgency, equity and compassion.
Time of India
2 hours ago
- Time of India
One cough too many: India's TB fight isn't quite there yet
Tired of too many ads? Remove Ads Tired of too many ads? Remove Ads MISSING CASES Tired of too many ads? Remove Ads NEW HOPE, OLD GAPS A CURE WITH ISSUES WHAT NEXT? One moment Anushka (name changed) was a college student. Then her world turned upside down. It started with a persistent cough and high fever. Despite popping meds, it wouldn't go away. Tests followed and then came the news that knocked the stuffing out of her—she had a fatal form of tuberculosis TB ). With scarred lungs, she gasped for each breath. The bacteria had killed her appetite, making her frail and bony. Her skin colour changed—to dark and then grew paler. At 20, her life expectancy dwindled to a few months.'I felt weak,' she recalls, 'and preferred to be alone.'Battling extensively drug-resistant tuberculosis or XDR-TB, a form of the disease in which drugs rarely worked, Anushka's only option was to be loaded each day with scores of tablets and injections. Those came with toxic side effects. For over four years, she moved between government and private hospitals, enduring cycles of failed came only when she was placed on a salvage regimen—the last option when all other interventions are exhausted—at a Médecins Sans Frontières (MSF) clinic in Govandi, Mumbai. The global humanitarian group offered Anushka a cocktail of bedaquiline , delamanid and imipenem injections, a set of very powerful meds often inaccessible to most Indians due to supply restrictions aimed at curbing drug who has now recovered, recounted her ordeal at MSF's TB Day event in Mumbai on May 12, speaking before an audience of doctors, a quiet smile breaking through years of pain. Her journey to recovery is rare, and alien to millions in India, which reflects a public health system still failing its most vulnerable. India now accounts for more than a quarter of all TB cases reported worldwide. In 2023, the country had 26% of the global TB burden, according to the World Health Organization (WHO). Bending the curve remains difficult despite multiple national can India improve?In 2018, when India pledged to eliminate TB by 2025, five years ahead of the set global target, the objective was clear. And progress has been made, too. Between 2015 and 2023, TB incidence (new and relapsed cases per 1 lakh population every year) fell by 18% and deaths by 24%, per is a sign in the right direction, but the number of cases are still astounding, especially when it comes to drug-resistant variants. 'India bears the highest burden of XDR-TB globally, with an estimated 110,000 new cases annually,' says Professor Anil Koul of the London School of Hygiene and Tropical Medicine. A key figure in TB drug research, Koul was part of a Johnson & Johnson team that developed bedaquiline, one of the most effective drugs against resistant TB notes that Covid-19 deepened the crisis, and underfunded research has stalled progress. Of the 27 drugs in clinical trials, none have reached Phase III. Bedaquiline remains the mainstay.A 100-day TB Elimination Challenge was launched by the government in December 2024 to amplify efforts to diagnose and treat TB at the village level, but experts aren't satisfied.'We are not on track,' says Dr Animesh Sinha, chronic care and infectious disease advisor, MSF. 'To meet the 2025 milestones of WHO's End TB strategy, India should achieve a 50% reduction in TB incidence rate and a 75% reduction in the total number of TB deaths compared with 2015.' Although numbers have fallen, the quantum has been woefully short of the target, as WHO numbers suggest.A PIB release dated March 24, 2025, says India's TB elimination targets for 2025 are an 80% reduction in incidence and a 90% reduction in deaths, compared with 2015.A key problem is underreporting emanating from under-diagnosis. India's notification rate (number of TB cases diagnosed and officially reported) has improved from 108 per 100,000 population in 2010 to 166 in 2023, yet many cases, especially in rural areas, go undetected.'In order to address the TB crisis, we have to find the missing cases,' says Sinha. Nonetheless, the 2025 goal helped push TB up the political agenda. Ni-kshay, a digital platform for notification and treatment monitoring, is improving reporting. But without proportionate investment in diagnostics, staffing and drug access, the pace of progress will be drug shortages have been reported, and India spent just 2.1% of the National Tuberculosis Elimination Programme budget on diagnostics till 2023-24, an IndiaSpend RTI revealed.'The 2025 target was always a stretch,' says Koul. 'But it did galvanise government machinery, leading to faster approvals for newer regimens like bedaquiline, speedier rollout across TB centres and more budgetary support, including for nutritional aid.'That said, TB continues to receive only a sliver of public health funding. But even so, he notes, there certainly is a positive trend in fighting back, considering the complexity of the disease and the socioeconomic factors shaping in an ET Morning Brief podcast in January, Dr Urvashi Singh, deputy director-general (TB), Ministry of Health and Family Welfare, said, 'The domestic budget for the national TB programme has increased over five times in the last 10 years.' India, she added, is the only high-burden country where 91% of the programme is backed by domestic detection is often the difference between quick recovery and years of suffering. Goa-based diagnostic device maker Molbio Diagnostics' Truenat, a portable molecular-testing platform, introduced in 2017, expanded diagnostic access, particularly in low-access regions. 'We supplied over 90 lakh testing kits last year and expect to provide 1.25 crore this year,' says Sriram Natarajan, CEO of Molbio, which is working with government and statelevel partners to rollout molecular testing.A Truenat test costs just Rs 640, a fraction of what imported diagnostics demand, says Natarajan. In public health, he argues, the real measure isn't price, but cost-effectiveness, especially when early detection can avert far greater globally approved diagnostics protocols remain out of reach in India. The WHO-recommended urine TBLAM test, used to diagnose TB in HIVpositive patients, is still unavailable in the country, despite successful validation studies in Mumbai in 2022. Registration barriers and lack of supply from manufacturers have led to lack of access, says Leena Menghaney, a public health lawyer based in Delhi. Supplyrelated issues could be because trials in India have yet to conclude, according to industry delays cost precious lives. Late detection risks high transmission rates and complications for patients. Dr Jennifer Furin, infectious diseases clinician, Harvard Medical School, says while Truenat is helpful and the diagnostic pipeline is robust, the outdated and slow systems for approving novel tools in India have a detrimental impact. Furin points to a critical gap: the lack of household-level prevention. Studies, including a 2023 trial published in TheLancet, show that modest nutritional support for families of TB patients can sharply reduce transmission. Another model, published in TheLancet this year, estimates that improving household nutrition alone could prevent nearly 5% of TB deaths by carrying the world's highest TB burden, regulatory reforms have been slow in India. Some gains have been made, but systemic delays continue to blunt the impact of new patients with drug-resistant TB, a new wave of treatment offers hope, but conditions apply. Regimens like a six-month, all-oral combination termed BPaLM— bedaquiline, pretomanid, linezolid and moxifloxacin—have been game-changers, replacing the gruelling 24-month regimens of daily injections and pills. 'These regimens are better tolerated and highly effective, with about 90% of people completing treatment successfully,' says clinicians welcome the government's push for shorter regimens, access remains limited—only 1,700 patients in India have received them, according to Dr Rupak Singla, head of the department of respiratory medicine, National Institute of Tuberculosis and Respiratory Diseases , Delhi, who spoke at the event in Mumbai. Adoption has lagged due to limited access to drug susceptibility testing for newer drugs, which is crucial for choosing an appropriate treatment BPaLM regimen can't be given in cases where more than one organ system is involved or in patients with severe extrapulmonary disease, 'both of which are common in India,' according to Dr Alpa Dalal, head of unit, Group of TB Hospitals, Sewri, Mumbai. BPaLM should not be prescribed for patients previously treated with bedaquiline, says Dalal, unless drug susceptibility to bedaquiline and linezolid is says even in extensive pulmonary TB, where studies have shown good outcomes with BPaLM, many clinicians are cautious. In longer regimens, patients with extensive lung involvement have had higher relapse rates, compared with patients with limited disease, she explains, and that concern carries over. A study published in OUP's research platform, Oxford Academic, in March 2025 shows that bedaquiline resistance among previously treated patients can reduce the drug's warn that such resistance could undercut its effectiveness in the long term if not addressed early. But Koul says, 'Bedaquiline has galvanised TB R&D. It will remain a core component of future regimens, unless we see a dramatic rise in resistance in clinical practice.'The economics of care create barriers too. Pricing is a big hurdle. Regimens with imipenem cost thousands of rupees per day. Anushka was treated free by MSF. Else each injection alone, she said, would cost Rs 2,499. Considering the socioeconomic realities of India, perhaps this is where the government could step approach to procurement is problematic too. The country selectively joins pooled procurement platforms like the Global Drug Facility, which could reduce costs. 'India has in the past refused to participate in this, unless they had an emergency,' says policy and procurement, TB is a profoundly social disease, shaped by stigma, poverty and undernutrition. Even the best drugs won't work if care doesn't reach those who need it most. Guidelines may improve and approvals may accelerate but until the system meets people where they are, too many will be left suffered for years before she got cured. Her strength wasn't just in surviving; it was in refusing to give up. 'Even in that condition, I completed my graduation and kept chasing my dreams,' she says. India's TB response must now rise to match that grit, with urgency, equity and compassion.
The Hindu
8 hours ago
- The Hindu
Bihar pushes up its Ayushman Bharat health insurance coverage
Bihar is now among the Indian States leading in the enrolment of cardholders under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY), with 3.94 crore Ayushman cards created till date, according to data released by the State government. It has also helped beneficiaries save over ₹1,000 crore in out-of-pocket medical expenses within a single year. Bihar is the third most populous State in the country, with about 80% rural population, and a literacy rate of less than 70%. It faces health challenges, including high infant and maternal mortality rates, malnutrition, and limited access to quality healthcare. As part of its drive to ensure maximum coverage, a recent four-day drive, from May 26-30, brought 17.38 lakh more cardholders into the Central government-run cashless health insurance scheme, offering treatment for secondary and tertiary care hospitalisation for the economically weaker sections of society. Uttar Pradesh and Madhya Pradesh are the other two States that have recently indicated a high enrolment rate. The flagship health insurance scheme, launched in 2018, offers cashless healthcare treatment of up to ₹5 lakh per family per year. Initially, the State Government had adopted the Socio Economic Caste Census (SECC 2011) data for implementing the AB-PMJAY scheme, Shailesh Chandra Diwakar, Administrative Officer, Bihar Swasthya Suraksha Samiti (Ayushman Bharat), said on the recent focus to expand the coverage of the Ayushman card. In February 2024, the Bihar Government adopted the National Food Security Act (NFSA) database and provided coverage to all NFSA-registered family members. 'This saw many more ration cardholders coming into the AB-PMJAY fold. More than 2.8 crore Ayushman cards were created in 2024,' Mr. Diwakar said. Besides this, the State has launched various measures, including an enhanced cash incentive of ₹15 (from ₹5) to ASHA workers involved in verified enrolments; camps at railway stations to capture those in need when people travel back into the State for festivals; and door-to-door campaigns. 'These extensive mop-up rounds are for individuals who have been left behind,' Shashank Shekhar Sinha, CEO, Ayushman Bharat (PMJAY-Ayushman Bharat Digital Mission), said. The State has also recently registered enrolment of 2.82 lakh persons under the Ayushman Vaya Vandana card (for senior citizens 70 years and above). According to the State government, the total claims paid rose from 3.03 lakh cases in FY 2023-24 to 7.52 lakh cases in FY 2024-25, and more than 2.83 crore Ayushman cards were created in 2024. A first time Ayushman card user, speaking of his enrolment, and experience with availing the treatment, said that he had had his card made only after he reached the hospital to be treated for cataract. 'Though we had heard about the Ayushman card, since we didn't need hospitalisation, we never got the card made,' Lalan Choudhary, a resident of Bihar's Nalanda district, who is now undergoing free treatment at a private healthcare facility in Gaya under the AB-PMJAY, said. 'This is a problem we are facing in the State — though people know about the card, they will enrol under the scheme often only when they seek treatment,' Mr. Diwakar added. The State is now trying to rope in eligible individuals who have not opted for the scheme. Khushi Praveen, 19, who was operated for spinal deformity 10 days ago, speaking about her use of the Ayushman card, said that she had been suffering for a nearly a year without money to secure treatment and surgery. 'Though I needed surgery, without money, there was no access to healthcare. My doctor in the private sector suggested that I get my Ayushman card and get operated. Using the card, I got surgery and am healing well now, and hope to be able to walk soon,' Ms. Praveen said. Parmilla Devi, 50, had her cataract operation performed under the scheme. 'My husband and I work as farmers and couldn't have afforded the surgery otherwise. My husband is also now planning to apply for his card also,' Ms. Devi said. Rajaram Prasad, Chief Surgeon, Gaya district, said that in Gaya district (one of the 38 districts in Bihar), which is seeing robust enrolment and use of the card, in 2024-25, a total of 18,734 people were treated in government hospitals at an expense of about ₹15 crore under the Ayushman scheme. 'Affordable, quality medical care is now no longer a distant dream for the rural population of Bihar,' Dr. Prasad said. Besides the enrolment of more individuals under the scheme, Bihar is also looking at enhancing the number of hospital service providers. Currently, over 1,100 hospitals are empanelled under the scheme in Bihar, 50% of which are private hospitals, a senior Bihar health official.
