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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 Unlikeliest Constant

Why India’s bond with Russia survives sanctions, summits and shifting global power.

In an era defined by broken alliances and transactional diplomacy, the India-Russia relationship has proved oddly resilient. While the West seeks to isolate Vladimir Putin over Ukraine and China tests the limits of American power in Asia, India and Russia continue to conduct business with an ease that defies geopolitical fashion. Their partnership, rooted in Cold War history but adapted to a fiercely multipolar present, has become one of the quiet constants of global politics.


India’s ties with Moscow stretch back to the aftermath of the second world war, deepening during the Soviet era and reaching their emotional peak under Indira Gandhi in 1971. Those were years when ideology and necessity aligned. The Soviet Union is long gone, and today’s India is scarcely the Congress-led, state-heavy economy of old. Yet the relationship did not fade with the red flag. It was rebooted in 2000 when Atal Bihari Vajpayee and Putin forged what they called a “special and privileged strategic partnership.” Narendra Modi has since made it more pragmatic, more commercial and no less durable.


Common Interests

The glue holding the relationship together is not nostalgia but interest. Russia offers what India needs at scale: defence hardware, energy, fertilisers and strategic depth. India, for its part, offers Russia a massive market, diplomatic breathing room and the legitimacy of engagement at a time when Europe and America keep their distance.


The war in Ukraine has only sharpened that logic. As western buyers recoiled from Russian crude, India stepped in with enthusiasm, becoming one of Moscow’s largest oil customers. Discounts eased India’s inflationary pressures while keeping Russia’s export revenues flowing. Washington protested. Delhi ignored it. Strategic autonomy, long a slogan of Indian diplomacy, suddenly acquired a very visible balance-sheet.


Behind the oil tankers lies a deeper strategic symmetry. Russia has pivoted from west to east, not out of philosophical conviction but because isolation has given it little choice. It now sees Asia, above all China and India, as its economic rear-guard. India, meanwhile, sees Russia as both hedge and partner: a hedge against American overreach, and a partner in weapons systems that Western suppliers are often reluctant to share on easy terms.


Defence Ties

Defence remains the hard core of the relationship. From fighter aircraft to missile systems and submarines, Russian technology still underpins large sections of India’s military machine. Even as India diversifies suppliers to include France, Israel and America, Russia remains the single most embedded defence partner. This explains why sanctions have dented, but not broken, military cooperation.


Economics, too, is being retooled. Bilateral trade has surged since 2022, heavily tilted in Russia’s favour because of energy imports. Both sides speak of pushing it towards $100 billion in the coming years. That will require India to sell far more than pharmaceuticals, tea and engineering goods. It will require Indian firms to understand Russian consumers, logistics snarls and payment systems insulated from the dollar.


There is also a demographic logic emerging. Russia, ageing and labour-starved, needs skilled workers. India, youthful and credential-rich, is keen to export labour. Agreements to place tens of thousands of Indian workers in Russian industry point to a new phase of engagement.


Modi has also sought to clothe realpolitik in culture. Visa relaxations, tourism drives and talk of reviving old cinematic and artistic exchanges evoke the 1970s, when Raj Kapoor was as beloved in Moscow as in Mumbai.


Yet this relationship is not without its cracks. Russia’s growing closeness to China unsettles Indian strategists who remain locked in an unresolved standoff along their Himalayan frontier. Moscow insists it can manage both friendships even as New Delhi quietly doubts it. Meanwhile, India’s parallel courtship of the West through the Quad, defence deals with America and trade talks with Europe, creates an inevitable tension with its Russian alignment. India insists it can walk multiple paths at once. So far, it has managed to do so with surprising agility.


The India–Russia partnership is neither sentimental nor revolutionary. It is conservative in the oldest sense: it preserves arrangements that continue to deliver power, profit and protection. In a world tilting towards blocs and binaries, India is betting that strategic ambiguity is still viable.

 

(The writer is a researcher and expert in foreign affairs. Views personal.)


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