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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.

The Arctic - Ice on Fire!

Updated: Dec 19, 2024

Arctic

Last week, Norway revealed its intention to establish a new joint warfare centre with NATO to train US, British, and Dutch marines in response to increasing tensions in the Arctic region. This new facility is designed to accommodate several hundred soldiers and is scheduled to be operational within two years. In the wake of the Russia-Ukraine conflict, to secure the Arctic region and the ‘GIUK gap’ for allies, NATO has expanded its reach to Finland and Sweden. Following this recent expansion, all the Arctic states except Russia have become a part of the NATO Clan. Meanwhile, in November this year, America signed the ‘ICE Pact’, a joint agreement with Canada and Finland, to build icebreakers for the safety and security of polar regions. Initially seen as drastic, Trump’s threat to exit NATO now appears to be a calculated move, following yesterday’s news that European nations would contribute €500bn to NATO’s defence fund. All these recent trends of militarisation suggest that the Arctic is no longer a ‘Zone of Peace’.


Beneath the layers of ice and snow, the Arctic holds the treasure of hydrocarbons, zinc, diamonds and gold, but severe weather and the harsh regional environment made resource exploration both challenging and economically infeasible. However, the recent surge in global warming has made this region more accessible than it was in the past. Today, the rapidly thawing ice sheet has exposed the hidden wealth more than ever. It has also opened the northern waterways for extended periods. The Northern Sea Route and Northwest Passage, of little importance in the past, are now gaining greater significance in maritime trade as prominent alternatives to traditional ways. These new routes are estimated to reduce the travel time between Europe and Asia almost by half compared to routes passing through the Suez or Panama Canal. As a result, the melting North has hardened the competition among the USA, Russia and other Arctic states, each attempting to expand their territorial claims for sovereignty and untapped economic gains. The matter has become complex not just due to overlapping claims of Arctic states, but also due to China, a state outside the Arctic region, seeking to access and exploit the region’s wealth.


The Arctic holds significant environmental and strategic importance for Russia as it stretches over 53 per cent of the Arctic coastline and relies heavily on the region for its energy resources. Consequently, it has a significant military presence in the Arctic. The country has a large military base along its Arctic shoreline equipped with radio-electronic warfare capabilities, hypersonic missiles and a dedicated Arctic military wing that conducts regular bomber sorties throughout the Arctic region. It has reopened approximately 50 facilities constructed during the Soviet era across its Arctic region. Russia remains the only country constructing and operating advanced nuclear-powered icebreakers. And now, it is developing nuclear-powered submarines to transport liquefied natural gas from the Arctic to Asia to reduce travel time. The recent Russian military drills, featuring nuclear-powered submarines and fighter jets, showcased the Russian might to function effectively in the Arctic’s extreme conditions, a skill that NATO troops lack. However, against the backdrop of Russia’s military operation in Ukraine and subsequent sanctions by the West, Russia had to look beyond Europe for investment and seek Yuan loans to strengthen its Arctic claim. This offered the opportunity for China to underpin its influence in the Arctic.


China is leapfrogging US containment efforts and is on track to challenge America’s superpower status by securing a network for its Arctic Silk Route. For example, over 55 per cent of the NATO member countries have agreed to be economic partners in China’s Silk Route Project. China plans to gain control of the Arctic region by exploiting America’s oversight and through investments in infrastructure, a path less travelled by any other non-Arctic state. Accordingly, China has been expanding its influence in the region by engaging with each Arctic state on a bilateral basis, and for all practical purposes, is becoming a ‘near-Arctic state’ despite being thousands of miles away.


On the other hand, US naval presence in the Arctic is outdated and inadequate compared to those of Sino-Russian operations. America’s North Warning System is now over 3 decades old and cannot track down Russia’s advanced hypersonic missiles. Very recently, the US DoD recognised the need for the Arctic force. The military personnel stationed in Alaska are now getting trained for extreme Arctic conditions. In other words, Russia is 30 years ahead of America in the Arctic region. America’s constant dithering elsewhere in the world and Sino-Russia progress in the Arctic Circle have made the Arctic vulnerable to Russian and Chinese expansion.


The recent scientific simulations suggest that the Arctic could be ice-free within 3 to 6 years. But the new Arctic Power Game among the US-China-Russia trio would surely set the Arctic ice on fire sooner than later.


(The author is an expert in foreign policies. Views personal.)

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