MAINS MARKS

MAXIMISER 2025

TOP TOPICS - LECTURE 1

Dates : 10-Oct-2024
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Topic Name: Left-Wing
D - Eradicating
t Extremism on its Last Legs: India’s Journey Towards
Maoism. - N R&
& D ra l
R n t
tral Evaluating the Decade of Decline in MaoistCInfluence
Subtitle: e (2014-2024) and Addressing
n the Long-Term Impacts on Affected Regions. IAS
UPSC CSE Mains 2025 Comprehensive Question:

“Left-Wing Extremism (LWE) is on its last legs due to sustained efforts by the Indian government at
both central and state levels. However, socio-economic challenges in Maoist-affected areas still
pose hurdles to complete eradication.” In light of this statement, critically analyze the progress
made in curbing LWE in India over the last decade. Discuss the role of development, security
measures, and state-level initiatives in reducing Maoist influence. How can the government ensure
sustainable development and governance in former Maoist strongholds after the insurgency ends?
a re
r e
( This is the question which will be visible in the mains 2025 )
o sh
s ha o t t
What is it : Maoists, also known
t to as Naxalites, are a communist insurgent group in India- N
that follow Mao

N o
Zedong's ideology, advocating
& D a classless society.
for a violent overthrow of the government to establish

D - armed attacks on security forces, destruction of government

Their activities include
l R infrastructure, and
extortion in& t a
r in India's central and eastern
R n
rural, tribal, and underdeveloped regions. They primarily operate

t ral known as the "Red Corridor."

regions,
C e
n S
IANaxalbari
CeThe Loop : The Maoist insurgency in India started with the Uprising in 1967, where peasants in
West Bengal revolted for land redistribution. By the 1970s and 1980s, Maoist influence spread to states
like Andhra Pradesh, Jharkhand, and Chhattisgarh, capitalizing on issues like tribal exploitation and land
rights. , exploiting grievances related to land rights and tribal marginalization. The formation of CPI
(Maoist) in 2004 united major Maoist factions, intensifying violence and guerrilla warfare. This led to
incidents like the Dantewada massacre in 2010, where 76 CRPF personnel were killed, and by 2010,
sh
t
Maoists had control over 223 districts across the Red Corridor. To counter this, the government launched to
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the Integrated Action Plan (IAP) in 2010, focusing on infrastructure development in affected regions. In
D
2017, Operation SAMADHAN was introduced, combining security, development, and rehabilitation
&
re ralR
efforts, which led to a 75% reduction in Maoist violence by 2020. By 2023, the number of Maoist-affected

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districts had decreased to 46, with incidents dropping to 541 and deaths down to 98. Despite these
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successes, pockets of Maoist influence remain in remote areas of Chhattisgarh, Jharkhand, and Odisha,
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driven by continued socio-economic challenges.
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Top 5 Challenges and Ideological Dilution of Maoist Insurgency
R
al
1. Romanticized Misconceptions Among Youth: Many young people hold romantic illusions about

ntr Maoism, idealizing it as a fight for justice without understanding its core ideology of violence, which
Ce undermines democratic institutions and creates governance vacuums through guerrilla warfare.
2. Violent Ideology Masked by Front Organizations: Maoists use Front Organizations led by intellectuals
to project a democratic facade, while masking the violent and authoritarian nature of their ideology.
These organizations mobilize people on issues like tribal displacement and human rights but
ultimately serve the insurgency's agenda.
are
3. Creation of Governance Vacuums: Maoists systematically target grassroots governance structures,

o sh tt
killing local officials and representatives, which creates a political vacuum that they aim to fill with their

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influence, coercing local populations to join their movement.
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4. Propaganda and Disinformation: The Maoists, through their propaganda machinery, exploit socio-

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economic issues, often making exaggerated claims about corporate exploitation and state violence.
R ra
al nt
This disinformation confuses the public and sometimes gains sympathy in the mainstream media.
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nt Ce
5. External Support and Alliances: The CPI (Maoist) has strategic alliances with other insurgent and
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terrorist groups, some of which are supported by external forces hostile to India. These alliances
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pose a significant national security threat, as they seek to create a united front against the Indian state.
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India's progress in curbing Maoist violence over the last decade:

R&D
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1. Decline in Affected Areas: Maoist-affected districts reduced from 223 in 2010 to 46 by 2023, reflecting
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ral e
a major contraction in their geographical influence.
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IAS
2. Reduction in Violent Incidents: Maoist-related violent incidents fell by 75%, from 2,213 in 2010 to 541
in 2022, with deaths dropping from 1,005 to 98 in the same period.
3. Surrender and Rehabilitation: Over 2,200 Maoists surrendered between 2014 and 2022 under the
government's rehabilitation policy, weakening the insurgent ranks.
4. Operation SAMADHAN: Launched in 2017, this multipronged strategy focuses on security, intelligence
sharing, targeted strikes, and development to combat Maoist insurgency.
5. Infrastructure Development: Over 5,000 km of roads were built in LWE-affected areas from 2014 to
2022, improving connectivity and reducing insurgent support.
6. Modernization of Security Forces: CRPF and state police have been equipped with drones, satellite
tracking, and modern weapons, enhancing their operational capabilities.
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7. Weakening of Strongholds: Maoist strongholds like Bastar and Jharkhand saw over 40% reduction in
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insurgency incidents from 2014 to 2023 due to sustained security operations.

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8. Leadership Decapitation: Top Maoist leaders, including Muppala Lakshmana Rao (alias Ganapathy),
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were killed or arrested, disrupting the Maoist command structure.
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Here are& 5 key strategic challenges of Maoist attacks faced by
t r
thea Indian government:
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1.lGeographical Terrain: Maoists operate in dense forests and
e n terrains, making it challenging for
ra C difficult
nt security forces to conduct operations. IAS
2. Local Support: Maoists often gain backing from marginalized and tribal communities due to issues like
poverty, unemployment, and land rights.
3. Ambush Tactics: Maoists use guerrilla warfare, including surprise attacks and ambushes, which make
them difficult to counter effectively.
4. Inadequate Infrastructure: Remote areas affected by Maoist activities often lack proper roads and
communication networks, hindering swift military and developmental responses.
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5. Coordination Issues: Lack of seamless coordination between central and state security forces hampers
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unified and effective anti-Maoist operations. o
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Most affected areas by Maoists in 2024:
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5 Most Affected States:
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1. Chhattisgarh: Continues to be the epicenter of Maoist activity, especially in the Bastar region.

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2. Jharkhand: Maoist presence is significant in the hilly and forested regions, particularly in areas like
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Latehar and Lohardaga.

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3. Odisha: Districts like Malkangiri and Koraput remain Maoist strongholds.
R
al
4. Maharashtra: Gadchiroli is a key Maoist hideout due to its forest cover and proximity to Chhattisgarh.
tr 5. Telangana: Areas like Bhadradri Kothagudem are affected due to their proximity to Maoist-affected
en regions in Chhattisgarh.
Key Districts:
1. Sukma (Chhattisgarh): Maoists use the dense forests and lack of infrastructure as cover.
2. Gadchiroli (Maharashtra): The forested terrain and bordering state make it a safe zone for insurgents.
3. Latehar (Jharkhand): Hills and forests provide natural cover for Maoist operations.

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4. Malkangiri (Odisha): Poor connectivity and tribal support have made it a Maoist hub.
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5. Bhadradri Kothagudem (Telangana): Borders Maoist-affected states, facilitating cross-border
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operations.
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Why These Areas Became Hideouts:
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Remote Locations: Difficult terrain, forest cover, and hilly areas provide natural hideouts.
l R tral
Lack of Infrastructure: Poor road connectivity and limited government presence make these areas ideal
ra n
ent for insurgent activities.
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Tribal Grievances: Maoists exploit local grievances related to land rights and resource access to gain
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support.
No &D
-
D creates multifaceted internal security challenges R
lfor India ?
How&
R maoism
tr a
n making it difficult for security forces to
ral1. Guerrilla Warfare and Ambushes: Maoists use guerrillaetactics,
S Cin ambushes, such as the 2010 Dantewada
A
combat them effectively. This leads to high casualties
attack, where 76 CRPF personnel were killed.I
2. Economic Disruption: Maoist activities disrupt development projects, such as infrastructure and
mining, especially in resource-rich states like Chhattisgarh, Jharkhand, and Odisha, impacting
economic growth in these regions.
3. Targeting of Infrastructure: Maoists routinely destroy critical infrastructure like roads, bridges, and
communication towers to prevent government access to their strongholds. For example, they have
destroyed hundreds of telecom towers, disrupting communication networks in affected areas.

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4. Humanitarian Impact: Maoist violence leads to displacement and creates insecurity among local

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populations, especially in tribal regions. Thousands of people have been displaced due to Maoist
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activities, worsening rural poverty.
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5. Strain on Security Forces: Continuous anti-Maoist operations drain resources and manpower of the
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central and state police forces, diverting attention from other critical security concerns, including
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terrorism and border management.
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ra
R& is related to other internal security challenges
Howl Maoism e n t
a in India ?
Cwith areas affected by other insurgencies,
ntr1. Overlap with Insurgencies: Maoist regions often Ioverlap
A S
such as in the Northeast and Jammu & Kashmir, creating a multi-front security challenge where
insurgent groups may share tactics and smuggling routes.
2. Link to Organized Crime: Maoists often engage in extortion and illegal mining to fund their activities,
contributing to organized crime networks in India, which complicates law enforcement efforts across
regions.
3. Communal and Ethnic Tensions: Maoist influence in tribal areas often intersects with underlying
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ethnic and communal tensions, such as land disputes and economic inequalities, which heightento
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local grievances and security issues.
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4. Strain on Resources: The focus on Maoist insurgency diverts significant security resources from
&
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dealing with other internal challenges like terrorism and border security, weakening the
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government's ability to respond to simultaneous threats.
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5. Undermining Governance and Development: By disrupting governance in rural and tribal areas,
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Maoism worsens issues of underdevelopment, poverty, and unemployment, which are also root
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causes of other forms of insurgency and radicalization across the country.

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OnceaMaoism ends, the affected regions will likely face several lingering issues of backwardness
t
n negative impacts that need to be addressed.
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1. Underdeveloped Infrastructure: Many Maoist-affected regions, like Bastar in Chhattisgarh and
Malkangiri in Odisha, have poor road networks, healthcare facilities, and schools. The lack of
infrastructure has left these regions isolated and underdeveloped, hampering economic growth and
basic service delivery.

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2. Poverty and Unemployment: Maoist-affected regions have some of the highest poverty rates in India.
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For example, Jharkhand and parts of Bihar suffer from high levels of rural poverty and unemployment
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due to limited industrialization and development, exacerbating economic inequality.
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3. Lack of Education and Literacy: These areas have historically had low literacy rates and poor

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educational infrastructure. In states like Odisha and Chhattisgarh, tribal populations often lack access
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to quality education, limiting opportunities for future generations.
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4. Psychological Trauma and Displacement: Years of violence and insurgency have caused mass
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displacement and psychological trauma in local populations. Regions like Dantewada (Chhattisgarh)
 t to - N
o &D
have seen thousands displaced due to Maoist violence, and rehabilitation and mental health support will
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-
be critical to rebuilding these communities.
R
R&D
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5. Erosion of Trust in Government: Long-term neglect and insurgency have left local communities
n
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distrustful of government institutions. Restoring effective governance and ensuring the delivery of

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services will be crucial to rebuilding public confidence in the state.
6. Resource Mismanagement and Environmental Degradation: Regions rich in natural resources, like
Jharkhand's coal mines and Odisha's forests, have seen rampant illegal mining under Maoist control.
Once the insurgency ends, the focus will need to shift to sustainable resource management and
environmental restoration to ensure long-term prosperity.

Role of key Forces Deployed by the Government in Maoist-Affected Areas and Their Impact
1. Central Reserve Police Force (CRPF): As India's primary counter-insurgency force, CRPF plays a major

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role in Maoist operations, particularly with its specialized units like the COBRA (Commando Battalion

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for Resolute Action). CRPF's deployment has been crucial in executing targeted operations in Maoist
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strongholds, significantly reducing insurgent activities.
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2. District Reserve Guard (DRG): Formed from local tribal youth, DRG is highly effective in Chhattisgarh,
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familiar with the terrain and local language. Their operations have led to several successful strikes on
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Maoist hideouts, drastically weakening the insurgency in the Bastar region.
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3. Greyhounds (Andhra Pradesh and Telangana): An elite force specializing in guerrilla warfare,
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Greyhounds are renowned for their swift and precise operations against Maoists in forested regions.
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They are credited with almost eliminating Maoism in Andhra Pradesh by 2024.
4. C-60 Force (Maharashtra): Maharashtra’s anti-Maoist C-60 Force has been instrumental in countering
Maoists in Gadchiroli. Their operations have significantly decreased Maoist attacks in the region,
improving local security.
5. Border Security Force (BSF): Deployed in states like Odisha and Chhattisgarh, the BSF assists in
guarding border areas and remote regions from cross-border Maoist influence and ensuring secure
communication routes. Their presence has stabilized many previously vulnerable areas.
s ha
t to
Impact: These forces, particularly CRPF and local units like DRG, have been instrumental in N o
shrinking
Maoist-affected districts from 223 in 2010 to 46 by 2023, with Maoist violence dropping -
D by 75% during
R &
the same period.
r e al
h a n tr
s
Top 5 Challenges and Ideological Dilution of Maoist InsurgencyC e
t to Among Youth: Many young people S hold romantic illusions about
o
1. Romanticized Misconceptions
IA
N it as a fight for justice without understanding its core ideology of violence, which
-
Maoism, idealizing

R &Ddemocratic institutions and creates governance vacuums through guerrilla warfare.

undermines

ral Ideology Masked by Front Organizations: Maoists use Front Organizations led by intellectuals
2. Violent
t
en to project a democratic facade, while masking the violent and authoritarian nature of their ideology.
These organizations mobilize people on issues like tribal displacement and human rights but
ultimately serve the insurgency's agenda.
3. Creation of Governance Vacuums: Maoists systematically target grassroots governance structures,
killing local officials and representatives, which creates a political vacuum that they aim to fill with

are
their influence, coercing local populations to join their movement.
sh
4. Propaganda and Disinformation: The Maoists, through their propaganda machinery, exploit socio-
o t to
tt -N
o
economic issues, often making exaggerated claims about corporate exploitation and state violence.
o
-N &D
This disinformation confuses the public and sometimes gains sympathy in the mainstream media.

&D al
R
5. External Support and Alliances: The CPI (Maoist) has strategic alliances with other insurgent and
R r
ral t
terrorist groups, some of which are supported by external forces hostile to India. These alliances
n
ent Ce
pose a significant national security threat, as they seek to create a united front against the Indian
C state.
IAS
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Government's Approach to Curbing Maoism
N &D
- R
1. Holistic Strategy: The government adopts a multi-pronged approach that integrates security measures,

R&D
tral
development initiatives, rights protection, governance improvement, and perception management to
n
ral e
address Left-Wing Extremism (LWE).
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IAS
2. Targeted Focus: Specific interventions are implemented in 38 districts across 9 states, identified as the
most affected, with close monitoring and coordination between the central and state governments.
3. State-Central Cooperation: Law and order being a state subject, the central government supports state
effortsthrough financial assistance, provision of forces, intelligence sharing, and infrastructure
development.
4. Regular Monitoring: The government ensures constant review and coordination, with meetings led by
the Union Home Minister and state-level officials to assess and enhance the anti-Maoist strategies.

Steps and Policies Taken by the Government

1. Security Related Expenditure (SRE) Scheme: Under the SRE scheme, the central government
are
sh
re
reimburses states for security costs in LWE districts, covering areas like training, operational expenses,
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rehabilitation of surrendered cadres, and ex-gratia payments. Rs. 2,348.81 crore has been released
since 2017-18.
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2. Special Central Assistance (SCA): Approved in 2017, this scheme focuses on filling critical gaps in
-N lR
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public infrastructure and services in LWE districts. Rs. 3,559.98 crore has been allocated to these
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regions to boost development.
R ntra
tral Ce
3. Special Infrastructure Scheme (SIS): This provides funds to states for security infrastructure, including
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the construction of 306 fortified police stations to enhance security in vulnerable areas, with Rs. 1,741
crore allocated to this initiative.
4. Civic Action Programme (CAP): Aimed at improving the relationship between security forces and
locals, the CAP funds civic welfare activities to bridge gaps and humanize security forces. Rs. 123.21
crore has been released for this since 2017-18.
5. Media Plan: To counter Maoist propaganda, the government uses media campaigns like radio jingles,
documentaries, and youth exchange programs to educate local populations and combat Maoist
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disinformation. Rs. 52.52 crore has been spent on this program.
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6. Road Requirement Plan (RRP-I): The construction of 5,168 km of roads in LWE-affected states (as of

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2023) enhances connectivity, boosts local economies, and weakens Maoist control over remote areas.

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7. Road Connectivity Project for LWE Areas (RCPLWE): Launched in 2016, this project sanctioned 12,228
re al
ntr
km of roads and 705 bridges, of which 9,266 km of roads and 428 bridges have been completed to
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date, ensuring better access to remote regions.
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8. Telecom Connectivity: As part of the effort to connect LWE-affected areas, 10,475 mobile towers were
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planned, and 5,373 towers have already been installed to improve communication infrastructure.

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9. Aspirational Districts Program: A development-focused initiative targeting 35 LWE-affected districts,
R
al
aimed at improving socio-economic indicators, governance, and infrastructure in these backward
tr regions.
en
10. Operation SAMADHAN, launched in 2017, is a comprehensive strategy by the Indian government to
tackle Left-Wing Extremism (LWE) or Maoist insurgency. The acronym stands for Smart Leadership,
Aggressive Strategy, Motivation and Training, Actionable Intelligence, Dashboard-Based KPIs (Key
Performance Indicators), Harnessing Technology, Agenda for Development, and No Access to
Financing. It integrates security forces' operations with developmental initiatives in Maoist-affected

are
areas, focusing on enhancing intelligence-sharing, modernizing security forces, and building
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infrastructure. By combining security with socio-economic development, the operation aims to weaken
o t to
tt
Maoist influence and reduce insurgency.
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-N &D
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These policies reflect a coordinated effort by the government to address the security and developmental
l R tral
challenges posed by Maoism, with a focus on long-term peace and stability in affected regions.
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Map- to R&D
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draw in mains
2025
A new updated
map will be
provided and
practised before
mains 2025 are
We will have 2 are sh
to
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maps -
No
representing the &D
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transition
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Story of 3 districts
1. Bastar, Chhattisgarh
Bastar has been one of the most heavily Maoist-affected regions since the insurgency's peak in the early

sha
2000s. The district’s dense forests and tribal population made it a stronghold for Maoists, who controlled
to
significant portions of the area. Years of violence, including ambushes on security forces and targeting of
t
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-N
infrastructure, crippled local governance. With the launch of Operation SAMADHAN in 2017, security

D
operations intensified, resulting in the weakening of Maoist leadership. Development initiatives,
&
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including road construction and community policing, have gradually reduced Maoist influence. By 2023,
r a
ha ntr
the number of violent incidents had dropped significantly, although pockets of resistance remain.
s C e
t to S
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2. Gadchiroli, Maharashtra
Gadchiroli, locatedN
A
near the Chhattisgarh border, became aImajor Maoist hideout in the 1990s due to its
D -
R& and security forces. The Maharashtra government deployed the C-60 Force, a specialized
forested terrain and isolation. Maoists controlled the region through intimidation and targeted attacks on
l
tratrained in guerrilla warfare, leading to several key victories against Maoist groups. Over time,
local officials
nunit
e improved infrastructure and the construction of fortified police stations weakened the Maoist presence.
By 2024, Gadchiroli saw a marked reduction in Maoist activity, with local governance and security re-
established in many areas.

3. Latehar, Jharkhand
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Latehar has been a major Maoist hub since the early 2000s, with insurgents using the region's hilly,
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forested terrain to launch attacks and maintain strongholds. Maoists here were notorious for attacking
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local officials and disrupting developmental activities. The government responded with increased
&D
&D
security operations, along with special infrastructure projects to improve roads and communication
R
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networks. Local recruitment for the District Reserve Guard(DRG) helped enhance counter-insurgency
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efforts. By 2024, the situation had improved with a steep decline in violent incidents, although occasional
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C IAS
Maoist activity still persists in remote areas.
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Topic : India at a Pivotal Moment: Evolving Challenges and the Path to Inclusive
N
Healthcare.
D - l R
R & t ra
n and Strengthening Public Health
ralSubtitle: Aligning Health Research with India's Ce
Needs
Infrastructure through PHCs and CHCs. IAS

UPSC CSE Mains 2025 Comprehensive Question:

India is at a pivotal moment in its healthcare journey, facing evolving challenges in healthcare
management and the need for inclusive healthcare. In this context, critically analyze whether
India's health research is aligned with its actual health needs. How can Public Health Centres

are
(PHCs) and Community Health Centres (CHCs) play a vital role in shaping India’s path to inclusive
sh
a re
healthcare? Discuss the importance of aligning healthcare research with local needs and the
to
sh
impact of healthcare infrastructure on rural health outcomes.
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- N &
R life expectancy, reducing
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India's healthcare system has made notable improvements, such as increasing
& and expanding public health schemes like Ayushman r
child R
l
mortality,
n t Bharat, which provides healthcare
a to millions. The country has also seen significant C e
ntrmore medical colleges and health centers. However,IA
coverage growth in healthcare infrastructure, including
S
challenges persist, including shortages of medical
professionals, particularly in rural areas, and underfunded public healthcare facilities, leading to over-
reliance on the private sector. Low fund utilization in government schemes and inadequate infrastructure
in primary and secondary care further hinder access to quality healthcare for all.

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Health of a nation :
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Health is crucial for a nation as it directly impacts economic productivity and overall development. A
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healthy population contributes to a stronger workforce, leading to improved economic outcomes. For
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instance, the World Health Organization (WHO) estimates that every $1 invested in health yields a return
re al
ntr
of $4 through increased productivity. In India, improving healthcare access, such as through the
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Ayushman Bharat scheme, which covers over 50 crore people, has helped reduce healthcare costs for

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the poor, enhancing their economic stability. Additionally, reducing the burden of diseases like
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cardiovascular diseases, which account for 28% of all deaths in India, can lead to a more productive and

&D
capable population, driving national growth.
R
tral
en
Research based challenges Faced by Indian Healthcare
1. Misalignment of Research Priorities: India's health research is often misaligned with the country's
disease burden. For instance, cardiovascular diseases contribute to 16% of the disease burden, yet

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only 5% of research publications focus on them, while cancer accounts for 5% of the burden but

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to
receives 22% of research attention.
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2. Underfunding of Public Health Infrastructure: A lack of adequate research on neonatal conditions,
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which contribute 14% of India's disease burden, reflects weaknesses in healthcare delivery rather
&D
&D
than research gaps, highlighting the need for better public infrastructure and healthcare
R
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implementation.
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3. Prevalence of Non-Communicable Diseases (NCDs): India faces a rising burden of non-
e
C IAS
communicable diseases (NCDs) like cardiovascular and respiratory diseases, which remain under-
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researched despite their growing impact, with NCDs now accounting for over 60% of deaths in the
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country. - R
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4. Global Influence on Research Agendas: Research in India is often shaped by high-income countries'
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(HICs) priorities, focusing on diseases like cancer, influenced by market demands and prestigious global

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journals, while more pressing local health issues receive less attention.
5. Public Health Delivery Gaps: Despite the availability of medical knowledge for diseases like diarrhoeal
diseases and neonatal conditions, poor implementation of public health policies and weak infrastructure
continues to drive high morbidity and mortality rates in India.

Challenges on ground
Shortage of Trained Healthcare Professionals: A significant gap in trained medical staff and
healthcare professionals across India hampers the quality of care, with rural areas facing the brunt of

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this shortage.

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Inadequate Healthcare Infrastructure: Healthcare infrastructure, especially in rural and semi-urban
s
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areas, remains underdeveloped, limiting access to quality healthcare services and contributing to
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poor health outcomes.
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Financial Sustainability: High treatment costs and limited affordability for patients, combined with
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financial pressures on healthcare institutions, challenge the sustainability of healthcare systems,
&D
especially private providers.
R ntra
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Patient Expectations and Quality of Care: Rising patient expectations for quality treatment and
n IAS
advanced care put pressure on healthcare providers to improve standards while dealing with
resource constraints.
Challenging Working Conditions: Working conditions in healthcare, including long hours and
resource shortages, lead to burnout among medical professionals, which further exacerbates the
shortage of skilled personnel.
Lack of Specialist Doctors in Rural Areas: According to 2021-22 data, two-thirds of specialist positions
in rural CHCs and one-third in urban CHCs remain vacant, impacting the ability to provide advanced
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healthcare in underserved areas.
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Fiscal Pressure on States: States are responsible for maintaining physical infrastructure created under
D
schemes like PM-ABHIM and HRHME, with financial support from the Union government ending by
&
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2025-26. This poses a challenge for states with limited fiscal space to sustain recurring costs.
e
a r tr a
sh e n
to
Importance of Public Health Centres (PHCs) and Community Health
S C Centres (CHCs):
ot
1. Primary Access to Healthcare
N IA CHCs serve as the first point of contact
for Rural Population: PHCs and
for nearly 65%-of India's rural population, offering essential healthcare services. They play a critical

R &D primary and preventive care to communities often far from urban hospitals.
role in delivering

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2. Cost-Effective
t
Healthcare: PHCs and CHCs provide affordable healthcare, crucial for rural and
en economically weaker sections. With out-of-pocket expenses being a major burden, these centers
offer free or low-cost treatment, significantly reducing the financial strain on vulnerable populations.
3. Vital for Maternal and Child Health: PHCs and CHCs are central to maternal and child health
programs, including safe childbirth, immunization, and nutrition services. These centers have
contributed to improving India’s maternal mortality rate (MMR), which dropped from 167 per

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100,000 live births in 2011 to 113 in 2020.
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4. Managing Disease Outbreaks: PHCs and CHCs are critical in disease prevention and control,
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6. Bridging Healthcare Gaps: With over 25,308 PHCs and 5,396 CHCs across India, these centers help

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key scientific and research-based steps taken by the Government of India, along with their launch
dates:
National Biopharma Mission (NBM):
Launched in 2017, this mission aims to boost innovation and research in the biopharmaceutical
sector by developing vaccines, biotherapeutics, and diagnostics, positioning India as a global leader
in biopharma.

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Atal Innovation Mission (AIM):

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Launched in 2016, AIM fosters healthcare innovation by promoting research and entrepreneurship in
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healthcare technologies, digital health solutions, and medical devices, particularly for startups and
young innovators.
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Pradhan Mantri Research Fellowship (PMRF):
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National Digital Health Mission (NDHM):
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Launched on August 15, 2020, NDHM aims to create a digital health ecosystem, enabling data-driven
healthcare through digital health IDs and electronic health records to support research on disease
patterns and personalized medicine.

Top Progresses in India's Healthcare:

1. Achieving Replacement-Level Fertility: India reached a Total Fertility Rate (TFR) of 2.1 (replacement
level) by 2020, 21 years ahead of projections made in 2007, demonstrating remarkable progress in
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population stabilization.
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3. Expansion of Health Insurance: Since 2018, the Ayushman Bharat scheme and other government
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5. Strengthening Primary Healthcare: Since 2018, the establishment of Health and Wellness Centres
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en (HWCs) has been a major initiative to bolster primary healthcare, though some states lag behind in
implementation.
6. Growth of AI and Digital Healthcare: India is embracing Artificial Intelligence (AI) and digital
technology in healthcare, from robot-assisted surgeries to AI-based clinical judgments, although
regulatory frameworks need to catch up to ensure ethical and accountable use of such technologies.

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1. Mental t
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changes, and lack of mental health awareness.A
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Anxiety Disorders: Impact around 38 million people, including general anxiety, panic attacks, and
obsessive-compulsive disorder (OCD), often driven by urban stressors.
Bipolar Disorder: Affects approximately 7 million people, characterized by extreme mood swings,
with limited awareness and mental health services.
2. Chronic Diseases
Cardiovascular Diseases (CVDs): Responsible for 28% of all deaths in India, fueled by lifestyle factors
like poor diet, lack of physical activity, and stress.

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Diabetes: India has 77 million diabetics, expected to reach 134 million by 2045, driven by unhealthy
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diets and a sedentary lifestyle.
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Chronic Respiratory Diseases (CRDs): Including asthma and COPD, affect 93 million people, with air

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Obesity: As per NFHS-5, 23% of adults are obese, particularly in urban areas, driven by poor diets
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Non-Alcoholic Fatty Liver Disease (NAFLD): Rising rapidly, affecting 25% of the population, linked to
poor diet and physical inactivity, and increasing the risk of liver complications.
4. Genetic Diseases
Thalassemia: Around 10,000 children are born annually with thalassemia major, a genetic blood

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disorder common in regions with higher rates of inter-family marriages.
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Sickle Cell Disease: Affects 1-1.5 million people, particularly in tribal communities, leading to chronic
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pain and anemia due to malformed red blood cells.
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Down Syndrome: Affects approximately 30,000 newborns each year, a chromosomal disorder
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Anemia: Affects 57% of women and 67% of children in India (NFHS-5), primarily due to poor nutrition
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6. Other Types of Diseases
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Cancer: Around 1.39 million new cases are reported annually, with breast, lung, and cervical cancers
tr being the most common. Rising pollution and poor lifestyle choices contribute to this increase.
en Tuberculosis (TB): India accounts for 26% of global TB cases, with 2.69 million cases reported
annually, remaining a major public health challenge despite efforts to curb it.
Dengue: India sees 100,000+ dengue cases annually, with rising urbanization and climate change
contributing to its spread through mosquito populations.
NCDs (Non-Communicable Diseases) Overview:
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NCDs such as cardiovascular diseases, diabetes, chronic respiratory diseases, and cancers now
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account for over 62% of deaths in India. Their rise is linked to lifestyle factors like unhealthy diets,
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physical inactivity, tobacco use, and alcohol consumption. NCDs are a growing burden and
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regular screenings, and vaccinations.
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Examples: Vaccinations (e.g., Polio, COVID-19), routine health screenings for early detection of
diseases like cancer and diabetes.
Cost-Effectiveness: It is generally more cost-effective, with WHO estimating that every dollar spent on
prevention saves $2-$4 in healthcare costs.
Impact: Preventive measures, such as India's Mission Indradhanush, have increased immunization
coverage to 90% in many states, reducing child mortality.
Goal: To reduce the incidence of disease and lower long-term healthcare costs by focusing on health
promotion and early intervention.
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medication
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Impact: India's Ayushman Bharat program, which covers hospital costs for over 10 crore families,
focuses on curative care, reducing financial burdens for hospitalization.
Goal: To heal or manage diseases after diagnosis, helping individuals recover or maintain health.

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More on preventive care
Cost-Effectiveness of Prevention: According to the World Health Organization (WHO), preventive s
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care can save up to $4 for every $1 invested. By reducing the need for expensive treatments, India
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can lower its out-of-pocket healthcare expenditure, which currently stands at 62% of total health
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Reducing the Burden of Non-Communicable Diseases (NCDs): Preventive care, through early

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detection and lifestyle interventions, can significantly curb the rise of NCDs, which account for 62% of
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all deaths in India. For instance, regular screenings for hypertension and diabetes can help prevent
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causes of mortality.
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Enhancing Workforce Productivity: Preventive care improves overall workforce productivity by

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reducing illness-related absenteeism. Studies show that healthier workers contribute to higher
en economic growth, with healthier nations experiencing 20-30% more GDP growth. Preventive
measures like routine check-ups and vaccinations can keep workers healthy, driving India's economic
progress.
Reducing Maternal and Child Mortality: Preventive care, such as antenatal care and vaccinations, has
been key to lowering India’s Maternal Mortality Rate (MMR), which decreased from 130 deaths per
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100,000 live births in 2014to 103 in 2019-2021. Programs like Janani Suraksha Yojana (JSY) have

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Tackling Infectious Disease Outbreaks: Prevention through vaccinations and health awareness
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campaigns has played a crucial role in managing infectious diseases. For example, India’s successful
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vaccinations helped save over 4.2 million lives as per the Ministry of Health and Family Welfare.
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The Indian healthcare system is largely curative in nature, focusing more on treating diseases after they
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occur rather than preventing them. While there have been efforts to strengthen preventive care, such as

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through immunization programs and health awareness campaigns, the majority of the system’s resources
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are still directed towards curative services like hospital-based treatments, surgeries, and managing

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chronic conditions.
Curative Dominance: The rise of non-communicable diseases (NCDs) such as cardiovascular diseases
and diabetes has led to increased spending on hospitalization and long-term treatments, with
schemes like Ayushman Bharat focusing on providing coverage for hospitalization costs rather than
preventive measures.
Preventive Gaps: While preventive care initiatives such as vaccination drives and health and wellness
centers (HWCs) under Ayushman Bharat are expanding, they still account for a smaller portion of the
healthcare system compared to the curative focus on treating illnesses.

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Thus, India’s healthcare remains largely curative, although there are growing efforts to enhance
preventive care to address long-term health challenges.
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