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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.

Forensic Battle Against Counterfeit Medicines

In India, counterfeit medicines have quietly become a serious threat, even reaching legitimate shops and hospitals.

India is now increasingly threatened by the growing menace of counterfeit medicines. Counterfeit medicines are fake drugs that look just like the real ones but might not work—or worse, they could harm health. Fake medicines often contain no real ingredients, wrong substances, or harmful chemicals, yet are packaged with labels, logos and seals to look authentic. In India, where medicines are used by millions every day, counterfeit drugs have quietly become a serious threat, even reaching trusted shops and hospitals. These illicit drugs find their way into legitimate supply chains. As counterfeiters grow more sophisticated, spotting and stopping these drugs is increasingly critical.


Counterfeiters target multiple parts of a drug’s presentation. They even exploit the names of reputed pharmaceutical companies to circulate fake medicines in the market, deceiving both regulators and consumers. Counterfeit tablets or capsules often mimic the colour, shape, and size of real drugs but may lack active pharmaceutical ingredients (APIs) or contain harmful substitutes. They differ in texture, weight, and dissolution. Common signs include incorrect fonts, misspellings, poor logos, fake QR codes or holograms that don't link to verification databases, and low-quality packaging. Batch numbers and expiry dates are often printed with non-standard inks, and tamper-evident seals are typically forged, lacking proper pressure sensitivity or adhesive bonding of the genuine products. Counterfeiters use fake licences and illegal manufacturers to dodge regulation.


India is tackling counterfeit drugs with a multi-layered strategy combining forensic science and regulation. Key steps include QR code-based serialisation for full drug traceability and upgrading state and central forensic labs into specialised pharma forensics units. These labs use tools such as Raman spectroscopy, infrared analysis, and AI databases. Experts use visual and digital autopsies to examine packaging and contents, while digital forensics from phones and computers uncovers networks. Fingerprint analysis links suspects to crime scenes, and psychological profiling aids in understanding perpetrators. This integrated approach helps to detect, trace, and dismantle fake drug operations to safeguard public health.


The Parliamentary Standing Committee's fifth report (2024–25) flags widespread spurious drugs and a misleadingly low 5.9% conviction rate. Of 2.3 lakh samples tested (2015–2019), 593 were spurious and 9,266 substandard, yet only 35 convictions occurred. In April 2025, 196 drug samples were declared ‘Not of Standard Quality (NSQ)—60’ by central labs and 136 by state labs. Similar concerns were raised in March 2025 and December 2024, when 135 NSQ drugs were flagged.


Key counterfeit medicine hubs in India include Delhi-NCR, Baddi, Kolkata, Patna, Mumbai, and parts of UP and Hyderabad. These areas are exploited for their pharma activity, weak oversight, and transport access, aiding fake drug production and distribution.


There is currently no centralised national database to track counterfeit medicine cases, which allows repeat offenders to secure bail relatively quickly after serving only a short period in police or judicial custody. Although violators are subjected to provisions under the Drug and Cosmetics Act, enforcement remains challenging.


In November 2024, the Supreme Court issued a notice based on a petition filed by the Indian Pharmaceutical Alliance seeking clear guidelines for prosecuting counterfeit drug offences. In March 2025, the Delhi High Court ruled in favour of Johnson & Johnson, imposing a ₹3.34 crore penalty on Medserve for selling counterfeit medical devices, emphasising the serious threat to public health.


ANTF and DCA Telangana have led multiple successful raids, seizing counterfeit, expired, and unlicensed drugs and arresting key offenders. These actions, supported by the Pharma Task Force and State Drug Officers, disrupted major fake medicine networks. Tackling counterfeit drugs is a critical public health issue, demanding stronger forensic tools, digital traceability, and coordinated national action to safeguard lives and the pharma industry’s integrity.


(Dr. Kumar is a former IPS officer and forensic consultant to Assam government. Das is a student of FSU, Guwahati. Views personal.)

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