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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.

Silicon Crossfire

A shaky truce in the US–China chip war has exposed the fragility of handshake diplomacy in the age of semiconductors.

In the 21st century’s hierarchy of strategic resources, semiconductors have replaced oil as the most contested commodity. They power the world’s most vital systems - from MRI scanners and fighter jets to smartphones and satellites. As digitalisation and automation advance, microchips are today cornerstones of both economic security and strategic independence.


The pandemic, followed by Russia’s invasion of Ukraine, laid bare a sobering truth that the global economy is dangerously dependent on an industry concentrated in a handful of places. Taiwan alone produces more than 60 percent of the world’s semiconductors and close to 90 percent of the most advanced ones. South Korea, Japan, China and America fill most of the remaining market. Such concentration leaves supply chains perilously exposed to pandemics, earthquakes and geopolitical sabre-rattling across the Taiwan Strait.


This vulnerability has set off a worldwide scramble to build domestic chipmaking capacity. America has rolled out lavish subsidies under its CHIPS and Science Act; the European Union has pledged billions to foster a ‘chips sovereignty’ of its own; Japan and South Korea are reinforcing their foundry capabilities. India, with its growing electronics industry and geostrategic ambitions, is pitching itself as a reliable alternative in an era of fractured supply lines.


Yet even as countries court new fabs and tout industrial strategies, an older battle has re-ignited in form of the ‘Chip War’ (to use the title of Chris Miller’s bestseller on the topic) - the technological cold war between Washington and Beijing, though now in a fresh and more convoluted phase.


In May, the two sides declared what looked like a modest truce. The Biden administration agreed to lift its ban on certain Nvidia chip exports to China, including the H20 - a deliberately watered-down processor designed to skirt earlier American export controls. In return, Beijing would resume exports of rare earths, minerals vital for electronics production and over which China holds a near-monopoly. The agreement, reportedly sweetened by revenue-sharing terms that would see chipmakers give the White House a 15 percent cut of sales to China, was greeted with relief in Silicon Valley. Jensen Huang, Nvidia’s boss, flew to Beijing in July, lavishing praise on China’s technological prowess.


The truce quickly crumbled. Rather than snapping up the newly approved H20s, Chinese authorities quietly told domestic firms to avoid buying American chips altogether, Nvidia’s and AMD’s in particular. The reasons appear two-fold. First, security concerns: Chinese policymakers fear the chips could contain hidden ‘kill switches’ or tracking capabilities, a suspicion bolstered by past moves such as banning Teslas near government sites and discouraging officials from using iPhones. Second, industrial policy: Beijing has poured billions into nurturing its own semiconductor sector, with Huawei leading the charge. While Chinese firms cannot yet match Nvidia’s most sophisticated models, they can compete with the mid-range H20.


From Beijing’s vantage point, the calculation is obvious. Why import an inferior chip that could be compromised when domestic alternatives, however imperfect, would strengthen local industry? For Nvidia and AMD, this is a nasty blow. China accounts for about 13 percent of Nvidia’s revenue and nearly a quarter of AMD’s. Both firms had banked on renewed Chinese demand to justify their concessions in the May accord. No sales mean no revenue, and no reason for Beijing to honour the spirit of the deal.


For Washington, the ‘mini-deal’ that Donald Trump championed now looks less like a clever compromise and more like a concession China never actually sought. It is also, characteristically, vague.


The fallout may yet force Beijing to soften. If Huawei and its peers cannot meet China’s domestic chip demand, particularly for artificial-intelligence workloads. China may have to turn back to Nvidia and AMD. American officials are betting on exactly that, hinting that more revenue-sharing arrangements could be floated if sales resume.


This dispute also carries lessons for the broader semiconductor race. First, that technology controls are blunt instruments. Efforts to hobble Chinese AI development by restricting chip sales have spurred, not stymied, China’s industrial policy. Second, supply chains built on mutual suspicion are brittle. If Taiwan’s chip foundries are the “single point of failure” in the current system, an emerging world of bifurcated tech ecosystems (one American-led, one Chinese-led) may prove even more fragile.


Meanwhile, the world’s appetite for chips is only growing. Cars are becoming rolling computers. Power grids and hospitals depend on sensors and processors. Artificial intelligence, with its voracious data-crunching needs, will require ever more sophisticated silicon. The more essential chips become, the more tempting it will be for governments to weaponise them.


For now, the silicon crossfire will continue and the rest of the world had better be ready for the shrapnel.

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