Keralam's health model on the ventilator?

Keralites in general feel proud of the unique model Keralam has created in the field of public health. It has already been demonstrated that Kerala’s health model is comparable even with that of Scandinavian countries. The state's health indicators are the best testimony of this. India’s infant mortality rate is 24 – meaning that out of every 1,000 babies born, 24 die before reaching the age of one. In Kerala, it is just six, the same as in the US. Similarly, Keralam is far ahead in health indicators, including vaccination rates. It has managed to contain Nipah outbreaks and, to a large extent, Covid, thanks to the quality of its health model. Despite these achievements, the weaknesses and recent challenges of the system also come in for discussion often. Health indicators in the tribal areas of the state are below the national average, infectious diseases are not being adequately controlled, and some unhealthy trends in the health department.  All these form barren patches in the health model. In the context of the drug shortage experienced in Kerala in recent days and the subsequent health emergency-like situation, concerns about the health model are once again looming.

The health department’s figures show that more deaths from infectious diseases have been reported this year than in previous years. This year, 114 people have died of leptospirosis and 120 of influenza. The number of malaria deaths in 2026 is 15; the health department has confirmed that about 50 people have died of dengue fever.  Reasons behind this health emergency are many, starting with shortcomings in pre-monsoon sanitation activities. As a result of Keralam’s famous health model, three-tier health centres are in place for prevention. Treatment facilities are available in the government sector, unlike in any other state in India. When we investigate why infectious diseases cannot be prevented properly, the harsh truth about the efficiency of these systems comes to the fore. It must be said that the health service systems are almost stagnant due to political and technical reasons. The current shortage of medicines illustrates this. Reports suggest that the functioning of the Kerala Medical Services Corporation, which is responsible for supplying medicines and related supplies to government hospitals in the state, has completely gone awry. When governments change, there are often changes in the leadership of many institutions. However, more attention was needed when making such changes in the essential services sector. Since that is not the case here, tender procedures have come to a standstill. This has now led to a shortage of medicines. As a result, the functioning of hospitals has come to a standstill. The shortage of essential medicines, from life-saving drugs to vaccines, has not yet been resolved.  Tens of thousands of ordinary people are affected by this. But what is unfortunate is that the authorities are not ready to accept this reality. They are trying to hide the fact by giving the issue a political cover.

The reactions and allegations made by the Opposition Leader and others on this issue are serious. The main allegation of the Opposition is that the government is deliberately creating a shortage of medicines through deliberate negligence and thereby creating an opportunity for local purchases. Who does not know that once permission is granted for local purchases, the benefits will go to big pharmaceutical companies? The other day, a WhatsApp message sent by the Director of the Health Department to DMOs and District Programme Managers confirmed this allegation. There is another background to this. Keralites are among the people who spend most on healthcare from their own pockets. Each person spends about Rs 8,000 annually on medicines and other healthcare needs. This amounts to 60 per cent of the total health expenditure. That is, Rs 28,400 crore. Multinational corporations are devouring all the major private hospitals in our country with an eye on this money. The only way to combat this trend is to strengthen the public health system as much as possible. Along with increasing infrastructure, what needs to be done urgently is to ensure the availability of medicines and related supplies. This is a priority for the government to ensure that our health model remains intact. However, instead of that, the health department is geared towards corporate service in a way that makes even its current excellence irrelevant. It is imperative that the government reverse this trend.