Sunday, 11 September 2016

An Open Letter to Citizens of Karnataka

The last two days of outrage expressed against my innocuous tweet on Bangalore bandh, has hurt me and pained me to the core. My tweet has been distorted and misinterpreted and used to hurl abuse and shame me, which is most unfair. I am shocked to see such negative vile being hurled at me from different quarters.

As a proud Kannadiga, I have worked tirelessly over decades in Bangalore not just as a businesswoman creating several thousand jobs but as a proud and responsible citizen, investing my personal time, energy and funds for the welfare of the people of Karnataka. I have utmost love and respect for my fellow citizens, especially farmers and am aware of the hardships faced by them due to acute water shortage and believe Karnataka's needs from Cauvery water must be addressed first.

However, I am of the view that Bandhs are not a solution to this grave issue, this long standing Cauvery water dispute needs to be settled through non emotional, evidence based amicable discussions between the two state governments.

Welfare Initiatives

Through my foundation I have been investing in creating sustainable livelihood solutions for people of Karnataka in nearly 100 GramPanchayats covering nearly 1500 villages for more than a decade. Through our initiatives in healthcare and education we have been touching several hundred thousand lives. 90% of our beneficiaries are farmer families across Mandya, Anekal, Hoskete, Chikaballapura, Dandelli, Coorg, Billagi, Bagalkot, Badami, Mangalguda, Kalkunte, Chikaballapur, Kaladgi, Halyal Vijayapur, Tumkur, Bijapur, Huskur, and Hennagara in Karnataka.

We have also built a township in Bagalkot where over 400 farmer families have been rehabilitated and provided sustainable living through houses equipped with solar lights and toilets and have access to clean drinking water through a water filtration plant. We have also set up a primary health clinic to provide them medical support and are also building a community centre and a primary school.
Since early 2000, through my philanthropy I have been supporting rural communities with comprehensive primary healthcare services through health clinics, management of malnutrition in children, early detection and prevention of oral & cervical cancer and management of diabetes & Hypertension. Under ‘Chinnara Ganitha’ program we have benefited over 7 lakhs farmers’ children across 1550 schools in Karnataka. We have developed and provided special text books to enable activity based learning to develop critical competencies in mathematics for the students of class 1 to class 7.

I am deeply concerned with the state of farmers and have therefore also collaborated with eKisaan Foundation to enable our farmers with technology that can empower them to take right decisions. Several hundred gram panchayats have been equipped with Tablets to benefit several thousand farmers in those regions.  This initiative of Biocon is helping farmers living in remote areas of Karnataka regularly access information needed for raising their crop yield in a cost effective manner.

For the city of Bengaluru, I have been personally engaging with the Government and various administrative departments to address various infrastructure challenges of the city.  As the founder member of B.PAC, I am selflessly investing in various initiatives to address ongoing challenges of the city and to improve the life of an average Bangalorean. However, despite my commitment to the city and state there are groups of people who have been targeting me with their spiteful comments which I find most deplorable and in extreme bad taste.

Cauvery River Water Distribution Facts

Cauvery river originating from Talakaveri in Karnataka has a length of 800 kilometer, of which 320 Km is in Karnataka and 416 km in Tamil Nadu with remaining across Kerala border. There are 3 dams constructed by Karnataka (KRS, Kabini and Harangi) which have a total capacity of 104 TMC of water, while Tamil Nadu has a total capacity of 136 TMC of water through its 3 dams (Mettur, Bhavani Sagar and Amaravathi).

Tamil Nadu’s irrigated lands have nearly doubled over the last 3-5 decades from an area of 1,440,000 acres to 2,580,000 acres, with 1,140,000 forest land being converted to farming land.  While Karnataka’s irrigated area has stood at 680,000 acres, with no changes to the irrigated lands.

Current Shortage of water

As per available public domain information Karnataka requires 81 TMC of water to cater to drinking water requirements and water for farming. However the total water currently available in all the 3 dams is only 56 TMC, out of which 22 TMC water is a dead water (below the dam gates). This indicates that Karnataka has a scarcity of 47 TMC of water currently to cater to its regular needs, while Tamil Nadu has been constantly demanding for the additional share of the water to sustain its additional agricultural activity.

With 90% of the monsoon season over and little or no further rainfall expected, Karnataka is facing a serious shortage of water to drink, yet has agreed to comply with the Supreme Court order of releasing additional water to Tamil Nadu, this reflects the large heartedness of Kannadigas.

However, at this moment Tamil Nadu Government‘s additional demand for more water to be released for their summer commercial crop is unfair.

In light of these unjust demands being made on Karnataka, the protest and agitation by the farmers is well placed, however the manner in which this is being done is not appropriate, two wrongs don’t make one right. The bandhs and violent protests not only hamper the common man and the daily wage earner but also impacts the overall productivity. One day of bandh leads to an economic loss of several thousand crores which impacts the health of the state and its people.

I would therefore urge both Karnataka and Tamil Nadu Governments to resolve this long standing water dispute through amicable evidence based discussions in the best interest of our farmers.

Tuesday, 9 August 2016

Ethics of Winning

I feel honoured to address the Fifth Convocation of the O.P. Jindal Global University. I am given to understand that this University is unique in many of its programs be it the multidisciplinary Masters of Arts program in Diplomacy, Law and Business or the Bachelor of Arts programs in Liberal Arts, Humanities and Global Affairs or the Jindal School of Government and Public Policy which is the first exclusive public policy school in India.  
It is these differentiated programs that have, in a very short time, become hallmarks of innovative excellence and thereby done its alumni proud.  I congratulate the founders and all the stakeholders of this great Institution.

Standing before you today, against the backdrop of the Rio Olympics, I can’t help but use the analogy of looking at the graduating Class of 2016 as qualifiers for Life’s Decathlon, an arduous race of guts, grit and endurance.  In fact the gold medallist of an Olympics Decathlon is often described as the ‘World’s greatest athlete’ because it is about the combined performance of an athlete across track and field events.  Just qualifying to get to this point is a proud moment but the course ahead is about competition and winning and above all, fair play.

Jobs and the Jobs Market

So let’s start with the first race the 100 meters sprint.  Every one of you is making a dash to get yourself employed, to find a job so to speak.  Some of you will find dream jobs in dream companies, some of you will be daring and join start-ups and some of you will even be gutsy enough to start your own companies and become entrepreneurs. Many of you will be disappointed and opt for what is available knowing that this is only the start of your life’s journey and that there are no winners or losers at this stage of the race. 

When I reflect on my own aspirations when I graduated from Ballarat University in Australia as India’s first woman Brew Master in 1976, I sprinted across the country to get a job in any Brewery that would hire me but that was not to be.  So I decided to be self-employed and start my own enterprise. In hindsight, I converted my failure into a hugely rewarding entrepreneurial success.

Today, the job market for young men and women is vast and varied.  Perhaps the most disruptive change is that of a shift in the societal mind-set that no longer seeks job security but job opportunity. Start-Ups have revolutionized the job market for young people whether they are techies or just entrepreneurial. Today India boasts of 25,000 start-ups valued at $75 billion employing nearly a million people.  India ranks third among global start-up ecosystems with 4 to 5 start-ups being born every day.  The Government, in its wisdom, has rightly come out with a policy for Start-Ups to make it that much easier for young enterprises to start, scale and endure.

Building expertise: Converting Knowledge to Wisdom

The next event in the Decathlon is the long jump, which is about immersing yourself in your chosen job by applying the knowledge that you have acquired at this great institution to gain experience and eventually expertise. This is what skilling and competence building is all about.  Computer education has created an enviable cadre of coders who have assumed global scale and competence and earned our country worldwide leadership in software services. Likewise, our biological scientists, chemists and pharmacologists have built global expertise in developing generic drugs and vaccines that have made a huge difference to global health.  India has earned the rightful title of “The pharmacy of the world” where one in three children in the world are immunized with a ‘Made in India’ vaccine and Indian generics account for a third of the global market.   Building on this success, the Indian Pharma sector’s “Make in India” strategy must be driven by a mantra of “Highest quality at the lowest cost” which will make a big impact on global healthcare.  In my own case, I am committed to making a difference to Diabetes and Cancer by providing affordable access to life saving drugs like Insulin and Biological Cancer Drugs.  I hope that over the next decade, one in five Diabetics around the world will use one of our Insulin products.  I have always believed that Blockbuster drugs are not about a billion dollars but about a billion patients.

Goals and targets

The third leg of Decathlon is the Shot Put. In context of your career path, it is about making intense efforts to achieve targets.  Credibility is built by achieving stated goals and as an entrepreneur, I have well understood the importance of overcoming credibility challenges.  When I started my company Biocon in 1978, I had huge credibility challenges.  I was a 25 year old woman entrepreneur who was trying to build a business based on an unknown field of Biotechnology. Banks were unwilling to extend credit or even lend to me, people were nervous of working for me and even traders were reluctant to do business with me.  I had to overcome a gender barrier, a genuine concern about being young and inexperienced and above all the lack of understanding of what Biotechnology was all about.  I went about overcoming these challenges by setting myself goals and with each intense effort I managed to obtain Bank credit, recruit people and make my first export sale of an enzyme which also was  the first for the country.

Aiming high, raising the bar

The next competition is the high jump which is all about raising the bar and aiming higher and higher. Unless you are willing to push yourself into this realm of excellence, you cannot win.  More importantly, you have to try over and over again to realize success.  Inability to jump the bar the first time is by no means a failure.  Every entrepreneur knows that nothing works perfectly the first time.  It’s only after several attempts that you finally realize success.  Steve Jobs was a perfectionist and it always took several versions before a Mac or an iPhone or an iPad was launched.  Just like it took Elon Musk several iterations before he brought Tesla to a waiting world.  

Success is an endurance race

The next is the 400 meters race which is a stamina test. Every one of us faces periods of fatigue, lack of job satisfaction and even serious doubts of whether it is worth pursuing one’s efforts. Endurance is the name of the game and those who endure come out stronger and more confident to rise to greater challenges and greater heights. This part of life’s journey or a career path is critical and whilst it’s easy to jump ship and escape stress, it’s tough to endure, overcome challenges and thereby build self-confidence, the traits of true leadership. Far too many young people are lured by the temptation to switch jobs to make an extra buck or to escape work related stress and data will tell you that these job hoppers never make meaningful impact as they fail to develop both experience and expertise.  As the saying goes, failure is temporary but giving up is permanent.

Overcoming obstacles – confidence building

The 110 meters hurdles is next.Every  career path is fraught with obstacles but overcoming obstacles is a confidence building exercise.  My own entrepreneurial journey has been an obstacle race which I have successfully overcome time and time again to build confidence, quell scepticism and drive leadership. This must also be your resolve as you step into your life’s journey.

Values and ethics – strategy for leadership

The next three events, the discus throw, the pole vault and the javelin are about lofty aims and higher goals.  There will come a time when you will need to have long term, strategic goals. Your responsibilities will shift from being task and activity oriented to problem gauging and problem solving.  This will call for strategic thinking that will enable you to create enduring value for you and the organizations that you serve.  This is what builds great companies and great leaders.  Integral to this is an uncompromising code of values and ethics.  Today’s sporting world is mired with doping controversies that have dented the ethos of fair play and sportsmanship.  In the context of business, whilst performance enhancement by leveraging new technologies is imperative, corrupt practices that provide surreptitious business advantage are akin to performance enhancers that are unethical and illegal. India ranks poorly in the ease of doing business which has led to speed money and high levels of corruption to deal with an over regulated economy.  The advent of the digital world has now brought focus on e-regulatory reforms that will deliver both transparency and traceability which will hopefully mitigate this malaise.

Sense of Purpose

Great companies and great leaders are driven by a deep sense of purpose. Elon Musk is driven by a mission to reduce global Warming through sustainable energy production and consumption thereby reducing the risk of human extinction!  Bill and Melinda Gates established their foundation on the belief that every life has equal value and have therefore focused their efforts to help all people lead healthy, productive lives by eradicating the world of infectious diseases, hunger and poverty. My own company Biocon is on a mission to make a difference to global health by providing affordable access to life saving drugs for Diabetes and Cancer. I urge every one of you to be guided by a sense of purpose and a spirit of challenge.  It will go a long way in building character and thought leadership. Remember, our country cannot aspire to economic greatness as long as India remains home to one-fourth of the world’s poor and a third of all malnourished children across the globe.

Hallmark of champions

The final lap is the 1500 meters run which crowns the champion.  At your career’s end or retirement, you will have run a long and fulfilling race, overcoming hurdles, crossing high bars and striking tough targets.  You would have competed with the best and won some races and lost others.  In the end it’s about how you ran the race.  Did you finish the race with a winning mind-set or did you simply give up mid-way because you lacked the stamina to endure?   As the saying goes, it’s not about winning or losing but about how you ran the race.

Beyond Decathlon: Team sports

Up until now, I have spoken about the individual but my message would be incomplete without stressing on the importance of team sports and team spirit.  The Olympics celebrates champions at the individual level but more importantly, at a team level and at a country level.  All of these resonate with the business world.  Whether it is synchronized swimming and organizational alignment in attaining stated goals or scoring winning goals in Hockey or smashing the volley ball to triumph, it’s about working together as teams with a shared vision to succeed.  When I reflect on my own success as an entrepreneur, I can honestly confess that I would be nothing without my incredible team at Biocon.  It’s people who steer organizations to greatness.  OP Jindal Global University’s success depends upon all of you to be its best global brand ambassadors.  As the great Brazillian saying goes, “When you dream alone it’s only a dream but when dream together it becomes reality.”


Today, we are at the cusp of a huge transformation. We are engulfed in a digital world where technology is disrupting our lives in unprecedented ways.  Uber and Ola are the new norm in public mobility. Flipkart and Amazon have displaced the Bricks & Mortar retail space with click and buy E-tailing stores. Wearable devices and smart phones have radically changed the way we manage our calendars, navigate our travel, watch movies, or buy tickets for anything from theatre to airlines. Today start-ups are capturing data, curating databases and monetizing information in a manner that was never thought of before. Robots are assembling automobiles and even performing surgeries. We have driverless cars and soon I suppose pilotless flights. We have 3D printing technology that can print bespoke organs or blood vessels or bones and joints.  The possibilities are endless but it will take painstaking efforts to build enduring businesses in this exciting virtual world.  Remember, no longer is value creation linked to scale but to the power of the idea.  We are today witnessing the birth of the “ideas economy,” where the value of a company is measured by its “innovation quotient” rather than traditional metrics such as revenue, profit, physical assets etc. The potential of the WhatsApp messaging platform to change the way the world communicates led Facebook to pay an “innovation premium” resulting in a blockbuster deal value of US$19-billion. The power of the idea is being reinforced by the dizzying valuations being commanded by companies like Snapchat (US$20 billion), Uber (US$65 billion) and our own home-grown companies like Ola 
($5 billion) and Flipkart ($15 billion)

Go out and innovate a bright future for our country by taking breakthrough ideas to the market, ideas that will end poverty, hunger and unemployment and provide equitable prosperity for all.

Ms Kiran Mazumdar-Shaw's Commencement speech at the 5th Convocation of O P Jindal Global University

Saturday, 30 July 2016

Biocon Advances In War Against Diabetes

Courtesy: Economic Times Blog 

There are nearly half a billion diabetes patients in the world. The alarming growth in the global diabetes population is leading to a huge demand for effective therapies from pre/early diabetes to late-stage disease. Of the 100 million people who need insulin globally, however, only ‘one in two’ can manage and afford costs associated with chronic insulin therapy.

As a leading insulins producer, Biocon is committed to provide affordable access to high quality insulins to patients worldwide through our differentiated portfolio, which includes rh-Insulin as well as basal and rapid-acting insulin analogs along with delivery devices. Our aim over the next 10 years to provide our insulin products to ‘one in five’ diabetes patients in need of insulin-based therapy anywhere in the world.

Already, our global scale capacities for manufacturing high quality, affordable insulins have positioned us as the largest Asian insulins player and the fourth largest producer of insulins in the world, enabling us to address the growing needs of diabetes patients across the globe. Globally, we are among the Top 3 biosimilars players in rh-insulin and Insulin Glargine in terms of market share.

Insulin Glargine Launch in Japan

In the beginning of FY17 we took a small but significant step in our journey to make a global impact in diabetes management through our affordable biosimilar insulins when our partner FUJIFILM Pharma launched our biosimilar Insulin Glargine in Japan. This is the first biosimilar from India and second biosimilar Glargine to be approved and launched in Japan. Importantly, this is also Biocon’s first biosimilar approval in a developed country.

Our product will provide a high quality, yet affordable, world-class long-acting biosimilar basal Insulin Glargine to the over 7 million people with diabetes in Japan.

As Japan has a reputation of very high expectations of product quality and manufacturing standards, the launch earns us huge credibility and validates our mission of delivering the highest quality at the lowest cost.

If fact, it is a testament to our commitment to quality and compliance that our manufacturing facilities were audited and approved by the Japanese regulatory agency, PMDA, on their very first inspection visit. It endorsed our strong R&D capabilities spanning process development, analytical characterization, and preclinical and clinical development, which were leveraged in submitting a comprehensive regulatory dossier to the Japanese health authorities.

The significance of the Japanese approval for Glargine goes beyond Japan as it will likely open some markets for us that rely on a developed country approval and provides confidence in terms of approvals in other developed markets.

Insulin Approvals in Malaysia

Our efforts to make our insulins more widely available also got a shot in the arm in the first quarter of FY17 with Biocon’s rh-Insulin becoming the first product manufactured at Malaysia to be approved for commercialization by the Ministry of Health (MoH), Malaysia. Biocon’s Insulin Glargine was also approved by the MoH, Malaysia. These approvals will open up commercialization opportunities for the company and will enable us to address the needs of nearly 3.3 million diabetes patients in Malaysia.

The commercialization of the Malaysian facility will augment our global scale in insulin production thus helping us achieve the ‘economies of scale’ needed to provide affordable insulin and insulin analogs to treat diabetes, which now affects nearly ‘one in 11’ adults globally. Regulatory filings for several other emerging markets are underway to enable commercial sales from the Malaysian facility.

Biocon is already recognized as Asia’s largest Insulin producer and our Malaysia facility will further strengthen our position as a global player.

The development of Insulin Glargine partnered with our partner Mylan is also tracking towards regulatory filings in the developed markets during this fiscal.

To address the diabetes burden in the US, we are collaborating with Lab PiSA to develop generic rh-Insulin. Biocon will be responsible for clinical development, regulatory approval and commercializing the product in the U.S. while PiSA would contract manufacture the drug product in their facilities in Mexico.

These significant developments at the beginning of FY17 have positioned us well to achieve our long cherished objective of providing affordable access to transformative, lifesaving biopharmaceuticals to patients across the globe.   

This piece was first published in the Plain Speak on Economic Times Blog on July 28, 2016

Tuesday, 5 July 2016

Book Review: Science of an Entrepreneur - by Karan Avtar Singh

Why Kiran Mazumdar Shaw? That is the question I asked myself when I saw this book. This biography is a recounting of very exciting times: An inflection point in Indian life sciences and enterprise. Kiran is one of the few persons who have combined excellence in enterprise and bioscience to become a leader in this sector. The book is not, strictly speaking, a biography; because it interweaves the stories of Biocon, Kiran Mazumdar Shaw’s personal life and India’s science sector as they rode the wave of the opening up of India’s economy over the last 25 years. 
The author’s deep understanding of science as well as of business and enterprise has helped in creating an engaging and simple narrative of an otherwise complex scheme. She skilfully navigates cell biology, biochemistry, medicine, finance, banking and corporate mergers and acquisitions without avoiding technical details and yet retains the excitement of innovation, experimentation, courage and foresight that emerge as the hallmarks of Kiran’s life and character.
There are three reasons why we should read this book. First, the style is neither journalistic nor pedantic, the author combines scientific discourse and corporate drama into an engaging narrative. Second, the subject matter which extends well beyond the life of Kiran to encompass the development of the biotechnology industry in India is of immense interest. Third, the numerous insights scattered liberally across this book merge to make a coherent tapestry of the lives of many eminent Indians in this field who chose to work in India to promote research and development in the life sciences. If anything, Kiran’s story is of an entrepreneur and a missionary who attracted the best minds in biotechnology to India and to Biocon with immense foresight and persistence. As they say, luck favours the brave.
The author unfolds several aspects of the title of her book Myth Breaker: Kiran is not only a pioneering woman scientist and entrepreneur in India, she is also instrumental in breaking the myth of India being unsuitable for cutting-edge research, development and production. 
Seema Singh highlights how Kiran was supported by her family, friends and colleagues. Beginning with this base of trust and faith, Kiran undertook multiple translational tasks. She first built an enterprise that bridged Ireland and India, then she filled several voids that existed in translating research into a viable product, and even transported people and ideas from developed countries to India. Kiran emerges as an achiever who saw opportunities when others did not and who had the courage to risk everything to pursue such opportunities. 
An important task of the biographer is to analyse events and trends to discover their underlying causes and thereby to develop a portrait of the subject’s character as it evolves over a lifetime. This process of discovery and analysis distinguishes a biography from a story. In this context, one is reminded of Irving Stone’s biography of the painter Vincent Van Gogh, titled The Agony and the Ecstasy, which was filmed as the movie Lust for Life by Vincente Minelli with Kirk Douglas playing the role of Van Gogh, the manic-depressive genius who produced some of the greatest paintings of the modern era. However, this first biography by the author lacks those personal insights that arise only as a result of painstaking research into the life of the subject. 
The book contains many insightful vignettes about friends and colleagues of Kiran Mazumdar Shaw, but it stops short of sketching a detailed and nuanced personal pen picture that a reader of a biography is looking for. What made Kiran take those crucial decisions that turned out to be life-changing events? How was she influenced by those closest to her and how did she influence them?
These most important and most personal questions are left unanswered. Perhaps, this is a fault one can find with most biographies of a living person for obvious reasons. There is a genuine need to protect privacy, and a felt need amongst those interviewed to preserve their private thoughts for themselves. The biographer’s failure to create the persona of the subject in full detail leads to a disconnect between the plot as its unfolds and its heroine. Whereas, the plot is fully choreographed and explains the bubbling energy of the biotech sector in India, Kiran’s pivotal role in these developments emerges only as a subtext. Surely, a more compelling way to tell this fairy tale of heady growth and rapid developments in life sciences in India would have been to place Kiran firmly in the limelight and show how events unfolded around the prima donna of India’s biotech drama. The story of her evolution definitely deserved centrestage in this book.
The book does a great job in describing the evolution of Biocon itself, especially, the pivot from opportunism to strategy when it had grown to a certain size and faced existential issues. To quote Kiran, ‘It’s all right to be opportunistic when you are building your business but when you reach a level of critical mass, you have to be strategic.’ Biocon had become the world’s largest producer of Pichia-based recombinant products, it was also a leading producer of insulin biosimilars, like Insugen, and so many companies sought partnerships with Biocon. One such partnership with Pfizer got off to a great start in October 2010 but then fizzled out. 
Kiran emerges as a persevering and patient entrepreneur who diligently pursues the best talent over a period of time, and offers them a workplace built on trust, recognition and generosity. As a result, many of the best brains in the life sciences end up working for Biocon where they graduated from academics and research to translation and enterprise by taking the ‘plunge’ into risky business situations. 
As Biocon grew, often standing on the shoulders of giants, Kiran Mazumdar Shaw evolved from a passionate scientist and entrepreneur to a mentor and guiding force in India’s biotech revolution. It is this central plot that is so well documented in this biography. For that inspiring tale alone, it is well worth reading.

This was first published in The Tribune on July 3rd, 2016

Thursday, 5 May 2016

A Collaborative Approach to Healthcare Delivery

Courtesy: TOI

The highest attainable standard of health is a fundamental right of every human being. In this context, universal access to healthcare assumes prime importance. However, healthcare delivery poses a significant challenge for policymakers in India.

A severe lack of resources means that there is only one doctor per 1,700 citizens in India, well below the minimum ratio of 1:1,000 stipulated by the WHO. There are also only 1.3 beds per 1,000 population, significantly lower than the other BRIC economies and the WHO guideline of 3.5 beds per 1,000 population. In rural areas and smaller towns of India, even basic health services remain inaccessible. Given the sorry state of affairs it is no surprise then that India continues to lag behind poorer neighbors like Bangladesh, Sri Lanka and Nepal in terms of child mortality. For every 1,000 children born in India between 2011 and 2015, 48 died on average every year before reaching the age of five, according to the World Bank. Equally alarming is the fact that a quarter of the world’s neonatal deaths and 15% of maternal deaths happen in India.

It is pertinent to note here that despite the fairly rapid pace of economic growth that India has experienced in the last 20 years, public health spending in the country is only about 1% of GDP. This compares to 3% in China, 4.1% in Brazil and 8.3% in the US.

Inadequate government spending on healthcare and lack of access to health insurance pushes almost 3% of India’s population into indebtedness and bankruptcy every year. To address this situation, the government needs to come forward and take proactive steps to implement a universal healthcare program that ensures basic healthcare services for everyone with minimum financial burden being passed on to the patient. 

India needs a universal healthcare program that hinges on affordability and access. This calls for existing public health infrastructure to be revitalized, new medical centres built and modern ICT-based telemedicine technology to be leveraged for addressing the demand-supply gaps in terms of doctors and health facilities. There is an urgent need therefore for public health spending in India to be raised to at least 2.5% of GDP as well as Public Private Partnership (PPP) models in healthcare to be promoted.   


The government alone cannot meet the healthcare infrastructure and capacity gaps in Tier II and Tier III cities as well as rural areas, and this makes private participation a must. While it’s true that some PPP projects attempted earlier have failed, clear policy guidelines can ensure the successful implementation and sustainability of healthcare PPP models in future.

The prerequisites should include agreed upon scope of work, legal and regulatory framework, resources pooling and management, transparency and accountability, suitable policies and a commitment to public good. It is necessary that PPPs ensure that government services are delivered in an economical, effective and efficient manner. The role of the government should be proactive and it should identify areas in National Health Programs, diagnostic and curative services where partnerships are possible. The government should also develop working guidelines based on successful experiences of different states besides framing quality guidelines with professional help from organizations that already have experience in preparing quality assurance tools. Lastly, smart business models need to be put in place without which it will be difficult for private players to achieve reasonable returns on investment.

It is encouraging to see that the NDA government is looking seriously at PPP models for improving healthcare access to the country’s 1.2 billion people and lessen the healthcare burden on the common man. At a time when the federal government is examining ways to implement healthcare initiatives under the PPP model in a time bound manner, states like Rajasthan have already set the ball rolling.


The Vasundhara Raje government in Rajasthan has partnered with the private sector for running Primary Health Centres (PHCs) and sub-centres across the state. Rajasthan, which is geographically the largest state in India, has over 500 Community Health Centres, over 2,000 PHCs and over 13,000 sub-centres. Several PHCs, which are located in remote areas, are now being run on a PPP model. The terms of the PPP engagement are simple. While the state government will provide the necessary infrastructure, medicines, equipment and operational costs, the private operator would provide doctors, paramedics and other staff, free outpatient services and 24-hour emergency services. These PHCs are already reporting encouraging results as the improvement in cleanliness and availability of staff and medicines  have led to a jump in the number of patients being treated.

The Rajasthan government has also launched a health insurance scheme to provide medical coverage of up to Rs 3 lakhs to each citizen and is expected to cover nearly 70% of the state’s population.

Health insurance is an area where PPP arrangements have been successful. The Yeshasvini Co-operative Farmer’s Healthcare Scheme, a PPP scheme involving Narayana Health and the Karnataka government, offers coverage of over 800 surgical procedures to farmers and their family members. Yeshasvini is one of the largest self-funded healthcare insurance schemes in the country. Neighboring Andhra Pradesh runs the Arogya Raksha Scheme in collaboration with the New India Assurance Company and with private clinics. The scheme, which is fully funded by the government, provides hospitalization benefits and personal accident benefits to citizens below the poverty line.


The new Companies Act of 2013 mandates corporates to spend 2% of their profits on CSR activities. The government can take this opportunity to partner with the private sector for taking healthcare delivery to the next level. It will lead to a huge improvement in healthcare delivery in India through a combination of good infrastructure, latest technology and the best available medical expertise. If PPPs are need based and customized to local circumstances, they clearly have the potential to drastically change the healthcare landscape in India.

PPPs can thus be a 'win-win' arrangement in which diverse actors with varied motivations and philosophies work together to contribute to the health of the people and the development of the country.

This piece was first published in the print version of TImes of India on May 5th, 2016

Friday, 25 March 2016

What Price Philanthropy?

                                                       Courtesy: Google Images
Over the past month, I have been a silent spectator, witnessing a miserable drama unfold in Bangalore. This is regarding a remarkable project to safeguard an important art collection through the upkeep and modernisation of an ailing state gallery the Venkatappa Art Gallery (VAG), by turning it into a new museum for the city. These plans were to be made possible through local corporate philanthropy. Sadly, the plans are currently in jeopardy as they are being protested by a group of ‘artist activists’ operating under the banner of the ‘VAG Forum’.