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By:

Rajendra Joshi

3 December 2024 at 3:50:26 am

Procurement first, infrastructure later

Procurement at multiples of market price; equipment before infrastructure; no accountability Kolhapur: Maharashtra’s Medical Education and Public Health Departments have been on an aggressive drive to expand public healthcare infrastructure. Daily announcements of new centres, advanced equipment and expanded services have reassured citizens long denied dependable public healthcare. Procurement of medical equipment, medicines and surgical supplies is reportedly being undertaken at rates two to...

Procurement first, infrastructure later

Procurement at multiples of market price; equipment before infrastructure; no accountability Kolhapur: Maharashtra’s Medical Education and Public Health Departments have been on an aggressive drive to expand public healthcare infrastructure. Daily announcements of new centres, advanced equipment and expanded services have reassured citizens long denied dependable public healthcare. Procurement of medical equipment, medicines and surgical supplies is reportedly being undertaken at rates two to ten times higher than prevailing market prices. Basic economics dictates that bulk government procurement ought to secure better rates than private buyers, not worse. During the Covid-19 pandemic, equipment and consumables were procured at five to ten times the market rate, with government audit reports formally flagging these irregularities. Yet accountability has remained elusive. The pattern is illustrated vividly in Kolhapur. The Dean of Rajarshi Shahu Government Medical College announced that a PET scan machine worth Rs 35 crore would soon be installed at Chhatrapati Pramilaraje (CPR) Government Hospital for cancer diagnosis. But a comparable machine is available in the market for around Rs 6.5 crore. A senior cancer surgeon at a major cancer hospital in western Maharashtra, where a similar machine was recently installed, remarked that the gap between what his hospital paid and what the government is reportedly paying was enough to make one ‘feel dizzy’. The label of a ‘turnkey project’ does not adequately explain a price differential of this magnitude. High Costs CPR Hospital recently had a state-of-the-art IVF centre approved at a sanctioned cost of Rs 7.20 crore. Senior fertility specialists across Maharashtra note that even a modern IVF centre with advanced reproductive technology equipment typically costs between Rs 2.5 crore and Rs 3 crore. The state’s outlay is reportedly approaching Rs 15 crore. Equipment arrived in June 2025 and lay idle for months owing to indecision about the site. Similarly, digital X-ray machines approved for CPR Hospital and a government hospital in Nanded; available in the market for roughly Rs 1.5 crore; were reportedly procured at Rs 9.98 crore per unit. Doctors in CPR’s radiology department, apprehensive about being drawn into potential inquiries, reportedly resisted accepting the equipment. One departmental head was transferred amid disagreements over signing off on the proposal. What’s Wrong These cases point to a deeper structural failure: Maharashtra has perfected what might be called the ‘equipment first, infrastructure later’ model. In any public hospital, the administrative sequence ought to be: identify space, create infrastructure, sanction specialist posts, and only then procure equipment. Compounding the procurement paradox is a parallel policy decision. On 20 December 2025, the state government decided to introduce radiology diagnostic services through a Public-Private Partnership model (PPP). Following this, an order issued on 6 February 2026 authorised private operators to provide PET scan, MRI and CT scan services at six government medical college hospitals: in Pune, Kolhapur, Miraj, Sangli, Mumbai and Baramati. CPR already has a 126-slice CT scan machine and a 3 Tesla MRI scanner, with another CT scan proposed. If the PPP arrangement proceeds, the hospital could simultaneously run one PET scan machine, two MRI scanners and three CT scan machines. Medical experts warn this could lead to unnecessary diagnostic testing simply to keep machines occupied, thus exposing patients to excess radiation while government-owned equipment gathers dust. A similar pattern was seen during the pandemic, when the Medical Education Department spent hundreds of crores on RT-PCR machines, only to award swab-testing contracts to a private company. Many of those machines remain unused today.

A Reckoning Beyond the Lab

As 2025 draws to a close, science and technology continue to shape global conversations. Artificial intelligence has become part of daily life. Space missions are more frequent and ambitious. New medicines are making their mark. Yet alongside this progress, public anxiety about technology, health, environment and data privacy has grown exponentially. Beneath the excitement and headlines lies a deeper concern that deserves reflection at the end of the year: public trust in science.


Science does not exist in isolation. Its real value emerges only when society understands, accepts and uses it wisely. Trust is the invisible link between laboratories and everyday life. When this link weakens, even strong scientific advances fail to deliver their full benefit.


Mixed Scenario

Across the world, public trust in science presents a mixed picture. In times of crisis, especially during health emergencies or natural disasters, people continue to rely on scientific advice. At the same time, scepticism has grown toward institutions, regulators, and large technology platforms. Many people trust science as a method, but question how scientific knowledge is produced, communicated, and applied.


India mirrors this global pattern. The country has achieved notable scientific successes in recent years. Space exploration, vaccine development, digital public infrastructure, and renewable energy initiatives have strengthened national confidence. Indian science has demonstrated its capacity to respond under pressure, and these achievements deserve recognition.


However, trust is not sustained by achievements alone. It is shaped by everyday experience. Citizens ask practical questions. Is the air safer to breathe? Is drinking water reliable and clean? Are new technologies tested carefully before adoption? Are medicines affordable and effective? When science appears disconnected from these concerns, trust weakens, often without loud protest.


Widening Gap

One major challenge is the widening gap between scientific complexity and public understanding. Modern science is complex by nature. Research papers are dense, data sets are large, and terminology is specialized. Complexity is unavoidable, but lack of clarity is not. Too often, findings are presented either as simplified slogans or buried in technical language. Both approaches damage trust. Oversimplification feels like promotion, while excessive jargon creates distance.


The media plays an important role in shaping perception. Science journalism has expanded, but it competes with misinformation, sensationalism, and the demand for instant attention. Early or incomplete findings are sometimes presented as major breakthroughs. Contradictory results are framed as failures rather than as part of the normal scientific process. Retractions and corrections, which reflect science correcting itself, are often portrayed as scandals. This confuses readers and weakens confidence. Social media has amplified these challenges. Direct communication between scientists and the public is a positive development. At the same time, unverified claims spread rapidly, often faster than carefully reviewed evidence. Individuals without scientific training can command large audiences, while expert voices struggle to be heard. Algorithms reward emotional responses more than accuracy, making trust fragile and easily distorted.


Another important factor is the perceived closeness between science, industry, and policy. Collaboration between researchers and industry is essential for innovation. However, when conflicts of interest are not clearly disclosed, public confidence suffers. People begin to question whether advice is driven by evidence or by economic considerations. Transparent disclosure and strong ethical frameworks are therefore essential.


The internal culture of science also influences public trust. Increasing pressure to publish frequently, secure large grants, and chase rankings has consequences. Quantity can overtake quality. Replication studies receive little attention and negative results often remain unpublished. When weak or flawed research enters public discussion, it does not remain a technical issue. It affects trust in science itself.


Education plays a central role in shaping long-term confidence. Scientific temper is not built by memorizing facts, but by understanding how knowledge is created, tested, corrected and sometimes rejected. Yet science education often emphasizes correct answers over questioning. Students learn conclusions without learning the process. This makes them vulnerable to misinformation later in life. India’s constitutional call to develop scientific temper remains highly relevant. Scientific temper does not mean blind faith in experts, nor constant suspicion. It means respect for evidence, openness to questioning, and comfort with uncertainty. Cultivating this mindset requires sustained engagement, not occasional campaigns.


Trust is also linked to inclusion. Communities that do not experience the benefits of science are less likely to trust it. When solutions ignore local realities, economic constraints or cultural practices, resistance is natural. Effective science communication treats citizens as participants rather than passive recipients.


Encouragingly, citizen science initiatives are gaining ground. Projects involving air quality monitoring, biodiversity mapping, water testing, and public health data collection have shown that participation strengthens both data quality and trust. When people contribute to knowledge creation, science becomes tangible and relatable.


Regulatory systems deserve equal attention. Transparent, competent, and independent regulators inspire confidence. Trust depends not only on outcomes, but also on clear and accountable processes.


In India, rebuilding trust will also require scientists to step beyond laboratories and journals. Engagement with schools, local communities, public forums, and regional languages can make science more accessible and humane. When scientists are visible, approachable and willing to listen, trust grows naturally, without persuasion or publicity.


At the global level, science diplomacy has become increasingly important. Challenges such as climate change, pandemics and resource scarcity require cooperation beyond borders. When scientific collaboration continues despite political tensions, it reinforces the universal value of evidence and reason. India is well placed to contribute meaningfully in this space.


Public trust in science cannot be taken for granted. It must be earned repeatedly. The future of science will depend not only on advanced technologies or larger laboratories, but on stronger relationships between science and society. As we turn the calendar, rebuilding and sustaining this trust may be the most important scientific challenge of all.


(The author is the former Director of the Agharkar Research Institute, Pune, a Visiting Professor at IIT Bombay, and among the first recipients of the ANRF Prime Minister Professorship.)

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