Healing with Science: Health Technologies

Health technology is the application of scientific knowledge and tools to prevent, diagnose and treat disease, from a vaccine vial to a telemedicine app. For UPSC, this is one of the highest-yield areas of science and technology: it connects the silent pandemic of drug resistance, India's push to eliminate tuberculosis, the vaccine platforms that made the country the pharmacy of the world, and the digital and traditional systems reshaping how care reaches a billion people.

The silent pandemic: antimicrobial resistance

Antimicrobial resistance (AMR) occurs when bacteria, viruses, fungi and parasites evolve so that medicines which once killed them no longer work. It is called the silent pandemic because it kills without headlines: routine operations, childbirth and chemotherapy all become dangerous when antibiotics fail. India is one of its global epicentres, which is why nearly every recent UPSC paper has probed some angle of it.

The drivers are well mapped. In clinics, broad-spectrum antibiotics are overprescribed for viral fevers, and weak enforcement of Schedule H1, the rule restricting over-the-counter sale of potent antibiotics, feeds a pill-popping culture; about nearly 55 percent of antibiotics consumed in India in 2019 belonged to the Watch category, drugs meant to be used sparingly. In farms, antibiotics such as colistin are routinely used as growth promoters in poultry and aquaculture, and India ranks as the world's fourth-largest consumer of animal antibiotics, with use projected to rise sharply by 2030. Drug factories add pharmaceutical pollution: untreated effluents have left stretches of Hyderabad's Musi river with antibiotic levels far above safe limits. Irrational fixed-dose combinations, cocktail drugs with no scientific rationale, led the government to ban 156 such combinations in 2024, while poor sanitation lets resistant bacteria travel from hospitals into rivers, soil and food.

The costs are counted in lives and rupees. More than 58,000 newborns die each year in India from drug-resistant infections, a 2013 estimate that the study's authors themselves called an underestimate; drug-resistant tuberculosis threatens the urban poor, and the World Bank has estimated that AMR could shave 3.8 percent off global GDP by 2050 through prolonged illness, expensive last-line drugs and lost productivity. India's response is organised around One Health, the recognition that human, animal and environmental health are one connected system. The National Action Plan on AMR 2.0 (2025-29) is the current national framework, building on the 2017 Delhi Declaration that brought ministries together. Visible instruments include the Red Line campaign, which marks antibiotic strips with a red stripe to warn against self-medication, the ban on colistin in animal feed, a May 2025 prohibition of 34 antimicrobial products in animal use, the ICMR AMR Surveillance Network, the India AMR Innovation Hub, anchored by C-CAMP Bengaluru, serves as the innovation arm of NAP-AMR 2.0, while Kerala and Gujarat have become the first states to ban over-the-counter antibiotic sales. The way forward that experts prescribe is diagnostic-led: rapid test kits at primary health centres so doctors stop prescribing blindly, cleaner pharma supply chains, farm-to-fork traceability for poultry, and behaviour-change campaigns that make finishing the full antibiotic course a social norm.

Training the immune system: vaccines

A vaccine is a biological preparation that trains the immune system to recognise and fight a specific pathogen, so the body defeats the real infection before it takes hold. Vaccines work by presenting the immune system with a harmless stand-in, a killed or weakened microbe, a fragment of it, or genetic instructions to make a pathogen protein, and letting the body build antibodies and memory cells in advance. This basic principle, expose safely now to protect later, underlies every immunisation drive on earth.

Four platforms dominate. Inactivated vaccines use killed pathogens, as in the polio shot. Live-attenuated vaccines use weakened pathogens that mimic natural infection, as in measles vaccine. Viral vector vaccines smuggle pathogen genes into cells using a harmless carrier virus. And nucleic acid vaccines deliver DNA or mRNA instructions so the body's own cells manufacture the target protein, the technology behind COVID-19 mRNA shots. India's manufacturers mastered all four during the pandemic. COVAXIN, an inactivated vaccine, and ZyCoV-D, the world's first plasmid DNA vaccine for COVID-19, granted emergency authorisation in August 2021 and delivered needle-free to adolescents, showed the range of indigenous platforms. GEMCOVAC-OM, an mRNA-based Omicron booster, extended it further.

Messenger RNA vaccines work by introducing a piece of mRNA that corresponds to a viral protein: the body's own cells read the instructions, manufacture the protein, and the immune system learns to recognise and attack it. Where most platforms inject the virus or a part of it, mRNA teaches the cell to make the antigen, which is why the same basic technology can be redirected to a new virus simply by rewriting the mRNA sequence. On safety, the key fact UPSC has tested is that the mRNA does not enter the cell nucleus and does not alter the recipient's DNA; it degrades naturally within the body. The trade-offs are speed and flexibility against complex manufacturing and cold-chain demands.

India's proof of the platform is GEMCOVAC-OM, developed by Pune-based Gennova Biopharmaceuticals with DBT and BIRAC funding under Mission COVID Suraksha. Granted emergency use authorisation by the Drugs Controller General of India in June 2023, it is India's first indigenous mRNA vaccine against the Omicron variant. Unlike imported mRNA shots that need deep-freeze chains, it is lyophilised, stable at 2 to 8 degrees Celsius in ordinary refrigeration, and delivered needle-free into the skin with the PharmaJet Tropis device.

The pandemic built on a deeper base. India supplies about 60 percent of the world's immunisation doses and is called the pharmacy of the world for good reason: it is the third-largest producer of pharmaceuticals by volume and a top supplier of generic drugs and vaccines globally. In January 2023 the Serum Institute of India launched CERVAVAC, India's first indigenously developed quadrivalent HPV vaccine against cervical cancer, developed with the DBT, BIRAC and the Gates Foundation, and launched on National Girl Child Day. The domestic backbone is the Universal Immunisation Programme (UIP), running since 1985 and now providing free vaccines against 12 diseases, tracked digitally through Co-WIN. The persistent challenges are vaccine hesitancy fed by misinformation, rural-urban gaps in coverage, cold-chain logistics, and staying ready for the next novel pathogen.

Ending an old killer: the TB elimination push

Tuberculosis (TB) is an infectious disease caused by the bacterium *Mycobacterium tuberculosis*, which most often attacks the lungs and spreads through the air when an infected person coughs or sneezes. It is curable and preventable, yet India carries 26 percent of the world's TB cases, about 27 lakh new cases a year, the highest national burden on the planet. That is why the National TB Elimination Programme (NTEP) is one of the most examined health missions in the syllabus.

The complication is resistance. Drug-sensitive TB responds to first-line drugs such as isoniazid and rifampicin. Multidrug-resistant TB (MDR-TB) resists both, needing longer, costlier second-line treatment, and India holds about 27 percent of the world's MDR cases. Extensively drug-resistant TB (XDR-TB) resists second-line drugs as well. Undernutrition is the single largest risk factor for TB in India, contributing to roughly a third of the burden, and stigma still keeps patients from seeking care early.

The programme's arsenal has expanded sharply. Nikshay Poshan Yojana pays Rs 1,000 a month directly to patients for nutrition during treatment, doubled from Rs 500 in October 2024,. The 100-day accelerated TB campaign of 2024-25 detected over 7 lakh cases through intensive screening. Newer drugs bedaquiline and delamanid have made drug-resistant TB treatment safer, and India has moved to an all-oral BPaLM regimen that shortens therapy to six months. Two indigenous TB vaccine candidates, VPM1002 and MIP (Mycobacterium Indicus Pranii, being developed as Immuvac) both proved safe, and VPM1002 showed 50.4 percent efficacy against extrapulmonary TB in the 12,717-person PreVenTB Phase III trial, published in The BMJ in April 2026, though neither worked against all forms of TB. Digitally, the Ni-kshay 2.0 portal unifies patient management and benefit transfers, TB Mukt Panchayat awards TB-free status to gram panchayats for local accountability, and Ni-kshay Mitra, under the Pradhan Mantri TB Mukt Bharat Abhiyaan, lets citizens and organisations adopt patients for nutritional support. The results are real: TB incidence fell 21 percent between 2015 and 2024, from 237 to 187 per lakh population, well ahead of the global decline, and treatment coverage rose from about 53 percent to 92 percent in 2024.

Regrowing the body: stem cell therapy

Stem cell therapy is the use of stem cells, the body's master cells that can both renew themselves and differentiate into specialised cell types, to repair, replace or regenerate damaged tissues and organs. Because a single stem cell can become bone, nerve, muscle or blood, the therapy promises what drugs cannot: rebuilding rather than merely treating.

Four types matter for the exam. Embryonic stem cells, taken from early-stage embryos, are pluripotent, able to become any cell type, but their use raises ethical objections about embryo destruction. Adult stem cells, found in bone marrow and fat, are multipotent, limited to a narrower family of cell types. Mesenchymal stem cells, from bone marrow, fat or umbilical cord tissue, are used in orthopaedic, cardiac and autoimmune treatments. And induced pluripotent stem cells (iPSCs), adult cells genetically reprogrammed to behave like embryonic ones, sidestep the embryo controversy entirely. Established uses include bone marrow transplantation for leukaemia, lymphoma and thalassemia, limbal stem cell grafts for corneal repair, and cartilage treatment; frontier research targets Parkinson's disease, spinal cord injury, diabetes through insulin-producing cells, and even lab-grown organs.

Graft-versus-host disease (GVHD) is a condition in which transplanted donor stem cells recognise the patient's body as foreign and attack it, causing skin rash, diarrhoea and liver damage. Transplant conditioning also wipes out the patient's immune system, inviting infection, and the procedures can cause infertility, nausea and fatigue. The regulatory line hardened in September 2026, when the Union health ministry directed states to act against clinics selling unproven stem cell therapies, for autism or anti-ageing for instance: stem cell therapy may now be offered only for listed conditions, 18 in adults and 14 in children, and the National Medical Commission has warned that prescribing it beyond approved indications counts as professional misconduct.

India regulates the field through the National Guidelines for Stem Cell Research (ICMR-DBT, 2017), which set the ethical and scientific framework, and under the New Drugs and Clinical Trials Rules of 2019, stem cell products are legally classified as drugs. The ICMR Stem Cell Registry tracks clinical trials, DBT supports facilities such as the National Centre for Cell Science in Pune, and Stempeucel, developed indigenously, became the first Indian stem cell product to win limited manufacturing approval from the CDSCO for critical limb ischemia. The caution UPSC expects: unproven stem cell clinics selling miracle cures remain a regulatory challenge, which is why the guidelines draw a sharp line between approved trials and commercial exploitation.

Health goes digital

Digital health is the use of digital technologies, telemedicine, electronic records, diagnostics software and data platforms, to make healthcare more accessible, efficient and personalised. In a country where specialists cluster in cities and patients crowd distant hospitals, the screen has become a stethoscope's extension.

The flagship is the Ayushman Bharat Digital Mission (ABDM), which builds a national digital health ecosystem on layered registries. Its foundation is ABHA, the Ayushman Bharat Health Account, a 14-digit health ID that gives every citizen a longitudinal health record across providers; over over 84 crore ABHA IDs had been generated by the end of 2025, crossing 90 crore in 2026. Above it sit the Healthcare Professionals Registry and the Health Facility Registry, and the Unified Health Interface (UHI) is the protocol meant to let any health app talk to any doctor or lab. On this rails run e-Sanjeevani, the free telemedicine platform that has served nearly 50 crore consultations as of September 2026, the e-Hospital system digitising over a thousand government hospitals, and the Integrated Health Information Platform (IHIP), which tracks 33 notifiable diseases in real time for outbreak response.

The fault lines are equally examinable. An alleged leak of over 10 lakh CoWIN user records in 2023 exposed data-security gaps. The digital divide persists, with rural internet penetration far below urban levels, which limits who can actually use these platforms. Many state systems still do not talk to private hospitals, ASHA workers struggle with data-entry apps, and algorithmic bias is a live concern as AI diagnostic tools trained on foreign data get deployed on Indian patients. The 2020 telemedicine guidelines were a start, but liability for AI-assisted diagnosis and prescription fraud remain under-regulated, the classic mains tension between innovation and safeguards.

Ancient wisdom, modern proof: traditional medicine

The World Health Organization defines traditional medicine as the knowledge, skills and practices based on the theories, beliefs and experiences indigenous to different cultures, used to maintain health and to prevent, diagnose or treat illness. In India this is not folklore on the margins: it is a recognised AYUSH system, an acronym for Ayurveda, Yoga and Naturopathy, Unani, Siddha, Homeopathy and Sowa-Rigpa, the Tibetan system added in 2010, administered by a dedicated Ministry of AYUSH created in 2014.

The institutional push has been substantial. The National Ayush Mission has operationalised 12,260 Ayushman Arogya Mandirs (Ayush) as of September 2026, against a target of 12,500, bringing traditional care into primary health infrastructure. In 2022 India hosted the WHO Global Centre for Traditional Medicine at Jamnagar, Gujarat, the first institution of its kind in the world, backed by a Rs 2,000 crore commitment, to build evidence, data and standards for traditional systems globally. Ayush-64, a polyherbal formulation clinically studied during COVID-19, became the emblem of evidence-based promotion, and an AYUSH Export Promotion Council now chases a multi-billion-dollar global wellness market, with Kerala and Uttarakhand drawing medical tourists for Ayurvedic therapies.

The scepticism is substantive and UPSC-grade. WHO itself notes the thin global evidence base for many traditional claims; reports of heavy-metal contamination in some Ayurvedic formulations have hurt credibility abroad; the Pharmacopoeia Commission for Indian Medicine and Homoeopathy is still building quality standards; the Drugs and Cosmetics Act of 1940 lacks uniform clinical-trial norms for herbal drugs; and the policy consensus emerging is integration with validation: mainstream AYUSH in primary and preventive care, especially where allopathy is thin, but only with the same pharmacovigilance and trials that modern drugs face.

When medicines fail: drug quality and regulation

India's title as pharmacy of the world rests on trust, and trust has been shaken. Deaths of children from diethylene glycol-contaminated cough syrups, in Gambia and Uzbekistan in 2022 and in Indian states in 2025, including the Coldrif cough-syrup tragedy in Chhindwara, Madhya Pradesh, where the syrup tested at 48.6 percent DEG and killed 24 children, exposed how weak domestic drug regulation can turn deadly. Understanding the regulatory architecture is therefore as much a governance topic as a science one.

The Central Drugs Standard Control Organisation (CDSCO), headed by the Drugs Controller General of India, is the national regulator for new drugs, clinical trials and imports, while State Drug Regulatory Authorities license manufacturing and sale within states. The governing law is the Drugs and Cosmetics Act of 1940, a pre-independence statute critics call outdated for biologics and complex global supply chains. The Act classifies failures precisely: not of standard quality (NSQ) drugs miss specifications; spurious drugs carry fake labels; misbranded drugs mislead; adulterated drugs contain toxic or filthy substances.

Reform is underway but incomplete. Schedule M of the rules was revised to align with WHO good manufacturing practices, special courts were created for drug offences, a scheme to strengthen state regulatory systems is upgrading laboratories, and the CDSCO now publishes monthly lists of NSQ drugs. The deeper fix experts demand is structural: replace the 1940 Act with a modern law covering biologics and medical devices, build a unified and genuinely empowered national regulator, staff and equip state authorities, and make approvals, inspections and recalls fully transparent. Quality, the argument runs, is what converts manufacturing scale into lasting soft power.

The world's first pandemic treaty

The WHO Pandemic Agreement is the first global treaty on pandemic preparedness, prevention and response, adopted on 20 May 2025 at the 78th World Health Assembly under Article 19 of the WHO Constitution. It is only the second legally binding instrument the WHO has ever adopted under that article, after the Framework Convention on Tobacco Control of 2003.

Negotiations began in December 2021, during the Omicron wave of Covid-19, driven by the memory of vaccine nationalism: wealthy countries locking up early vaccine supplies while developing countries waited, and supply-chain breakdowns that left health systems exposed. Later studies estimated that more equitable vaccine distribution could have saved over a million additional lives.

The agreement seeks to strengthen international cooperation on surveillance, research and equitable access to vaccines, diagnostics and treatments, so the next pandemic does not repeat the access divides of Covid-19. For India, which positioned itself as a supplier of affordable vaccines and medicines, the treaty is both a responsibility and a strategic opening.

Beyond infections: India's NCD transition

Non-communicable diseases (NCDs) are medical conditions not caused by infectious agents, usually of long duration and slow progression. The big four are cardiovascular disease, diabetes, cancer and chronic respiratory illness. They now account for roughly 63 to 65 per cent of all deaths in India, up from about 38 per cent in 1990, a transition driven by urbanisation, ageing populations and changing diets.

The sting is in the age profile: about a quarter of NCD deaths in India occur between ages 30 and 70, striking people in their prime productive years. That makes NCDs not just a health issue but an economic one, eroding household incomes and workforce productivity decades before retirement age.

The global net against superbugs

India does not fight AMR alone. GLASS, the Global Antimicrobial Resistance and Use Surveillance System launched by WHO in 2015, standardises how countries track resistant infections, so outbreaks can be compared across borders and spotted early.

GARDP, the Global Antibiotic Research and Development Partnership backed by WHO, funds new antibiotics for drug-resistant infections that commercial markets ignore. Its SECURE programme works to expand access to essential antibiotics in low- and middle-income countries, while Carb-X, another global nonprofit partnership, accelerates early-stage antibacterial innovation.

The way forward, as global agencies frame it: update the 2015 Global Action Plan on AMR through the Quadripartite of FAO, UNEP, WHO and the World Organisation for Animal Health; write defined antibiotic-use policies for hospitals; promote alternatives to antibiotics; expand financing instruments; and run the whole effort as One Health, linking human, animal and environmental health.

TB's final push: new weapons

The regimen revolution has arrived. India has moved to the BPaL/BPaLM all-oral regimen for drug-resistant TB, phasing out painful daily injections: the six-month BPaLM course is markedly more effective than older treatments, and oral bedaquiline-based regimens have pushed DR-TB treatment success from 68 per cent in 2020 to 75 per cent by 2022. Newer drugs bedaquiline and delamanid are now rolled out for safer, more effective drug-resistant TB care.

Vaccines may be next. India is in advanced Phase III trials for two TB vaccines: VPM1002, a recombinant BCG vaccine, and MIP (Mycobacterium indicus pranii), an Indian-developed candidate.

The numbers show the push is working: TB incidence fell 17.7 per cent between 2015 and 2023, double the global average decline of 8.3 per cent, while treatment coverage rose from about 53 per cent in 2015 to 85-89 per cent by 2023. New instruments include the Ni-kshay 2.0 portal for unified patient management and benefit tracking, and the TB Mukt Panchayat initiative, which awards TB-free status to gram panchayats to build local accountability.

Trachoma and the neglected diseases

Trachoma is a bacterial eye infection caused by Chlamydia trachomatis, spread through eye secretions, fingers, clothes and flies, and classified by WHO as a neglected tropical disease; untreated, it blurs vision and can cause blindness. WHO declares trachoma eliminated as a public health problem when trichiasis prevalence falls below 0.2 per cent in people over 15 and active trachoma below 5 per cent in children aged 1-9. India met these criteria and became the third country in South-East Asia, after Nepal and Myanmar, to eliminate trachoma.

Trachoma sits inside a bigger map. Neglected tropical diseases (NTDs) are a group of 21 conditions prevalent in tropical and subtropical regions, affecting over a billion people in impoverished communities, and caused by viruses, bacteria, protozoa and parasitic worms. They are called neglected because they are nearly absent from the global health agenda, receiving less than 0.6 per cent of global health funding despite their burden, and India carries the world's largest absolute burden of at least 10 major NTDs. The WHO NTD Roadmap 2021-2030 charts elimination targets; progress needs funding, surveillance, and honest attention to stigma, climate-driven spread and drug resistance.

Nobel 2025: the immune system's peacekeepers

The 2025 Nobel Prize in Physiology or Medicine went to Mary Brunkow and Fred Ramsdell (USA) and Shimon Sakaguchi (Japan) for discoveries on peripheral immune tolerance. Sakaguchi discovered regulatory T cells (Tregs) in 1995; Brunkow and Ramsdell showed in 2001 that mutations in the FOXP3 gene cause the rare autoimmune disease IPEX; Sakaguchi then linked the two, showing FOXP3 controls Treg development.

A regulatory T cell is a specialised T cell that stops the immune system from attacking the body's own tissues. Peripheral tolerance is the system of checks in body tissues that keeps leftover self-reactive cells from activating, and Tregs are its central enforcers. Their failure underlies autoimmune disorders such as rheumatoid arthritis, type 1 diabetes and multiple sclerosis, which is why the discovery opens new therapeutic doors.

Three-parent babies: mitochondrial donation

Mitochondrial donation treatment (MDT), also called mitochondrial replacement therapy (MRT) or the 'three-parent baby' technique, is a specialised in-vitro fertilisation (IVF) technique designed to prevent the transmission of mitochondrial diseases from mother to child. It uses the nuclear genetic material of the parents and the healthy mitochondrial material of a donor: the baby carries almost all its DNA from its parents and a small fraction, about 37 genes, from the donor.

In May 2023 the UK's Human Fertilisation and Embryology Authority confirmed the first British babies born through MDT, fewer than five at the time, with more than 99.8 percent of their DNA from the parents. Britain had become the first country to legalise the technique in 2015, using maternal spindle transfer or pronuclear transfer at the Newcastle Fertility Centre; the first such birth anywhere was in Mexico in 2016.

In India the procedure is not currently permitted, and ethicists argue that any introduction would need a dedicated regulatory body, proper clinical trials and safeguards against the exploitation of egg donors, alongside answers on the child's identity rights, equitable access and the technique's still-experimental safety record.

Key Terms

• Health technology: Health technology is the application of organised knowledge and skills in the form of devices, medicines, vaccines, diagnostics, procedures and digital systems to solve health problems and improve quality of life. Because resources are limited, new health technologies are assessed for safety, effectiveness and cost-effectiveness through Health Technology Assessment before being adopted into public programmes. In India, HTAIn under the Department of Health Research performs this evaluation role. Example: India's HTAIn evaluates which new diagnostics and medical devices offer enough value to be included in public health programmes.
• silent pandemic: The silent pandemic is the term used for antimicrobial resistance (AMR), because resistant infections spread and kill without the sudden visibility of an outbreak, steadily eroding the effectiveness of antibiotics. The WHO lists AMR among the top global public-health threats, and overuse of antibiotics in medicine and livestock is its main driver. India adopted a National Action Plan on AMR in 2017 to coordinate surveillance and stewardship. Example: Drug-resistant tuberculosis strains that no longer respond to first-line drugs are a visible face of the silent pandemic.
• pharmacy of the world: Pharmacy of the world is the title given to India's pharmaceutical industry, the largest global supplier of generic medicines and vaccines by volume, serving affordable drugs to developing countries. Built on process-patent expertise and cost advantage, it proved vital during health crises. For UPSC GS-3 and GS-2 it anchors answers on industry, health diplomacy and IP policy. Example: Vaccine Maitri, India's supply of Covid-19 vaccines to partner countries in 2021
• Schedule H1: Schedule H1 of the Drugs and Cosmetics Rules, 1945 (introduced in 2013) lists prescription-only medicines, including specified antibiotics, anti-tuberculosis drugs and habit-forming medicines, that cannot be sold without a registered medical practitioner's prescription. Chemists must maintain records of these sales to curb misuse and antimicrobial resistance. It is part of India's drug-scheduling system that also includes Schedules H, X and others. Example: Third and fourth generation antibiotics can only be dispensed against a prescription under Schedule H1.
• Watch category: The Watch category is one of the three groups in the WHO's AWaRe antibiotic classification (Access, Watch, Reserve) used to combat antimicrobial resistance. Watch antibiotics have higher resistance potential and should be used sparingly, only for specific infections, unlike Access antibiotics which are first choice treatments for common infections. India faces a serious concern here, with a large share of antibiotic consumption falling in the Watch category, driven by over the counter sales and irrational prescribing. Example: Commonly used antibiotics such as azithromycin and ciprofloxacin fall in the Watch category, and their overuse accelerates drug resistant infections.
• colistin: Colistin is a polymyxin antibiotic reserved as a last-resort treatment for multidrug-resistant Gram-negative bacterial infections in humans. Its routine use as a growth promoter in poultry and aquaculture accelerates antimicrobial resistance, which is why regulators have restricted such use. Example: India banned the use of colistin as an animal feed additive in 2019 to protect its effectiveness as a last-resort human medicine.
• pharmaceutical pollution: Pharmaceutical pollution is the contamination of water and soil by drug residues from manufacturing effluents, hospital waste, improper disposal, and human excretion. Antibiotics in waterways are especially concerning because they can accelerate antimicrobial resistance in the environment. Manufacturing hubs with weak effluent treatment are major hotspots. Example: The near-extinction of India's vultures after the veterinary painkiller diclofenac poisoned birds feeding on treated cattle carcasses, leading to its veterinary ban in 2006.
• fixed-dose combinations: Medicines that combine two or more active ingredients in a single pill or dose in a fixed ratio. Rational FDCs improve treatment adherence and can be clinically superior, as with tuberculosis or HIV drug cocktails. Irrational FDCs, combinations with no therapeutic justification that are marketed to differentiate brands, are a major public health concern in India because they expose patients to unnecessary drugs, encourage antimicrobial resistance and complicate adverse reaction tracking. Example: In 2016, the Government of India banned 344 irrational fixed-dose combinations after an expert committee found them lacking therapeutic justification.
• One Health: One Health is the integrated approach that treats human, animal, and environmental health as interlinked, since most emerging infections are zoonotic. India has institutionalised it through the National One Health Mission, steered by the Principal Scientific Adviser with ICMR as implementing agency. For UPSC, it is the standard framework for answers on pandemic preparedness, antimicrobial resistance, and climate-linked disease. Example: Joint surveillance of avian influenza across poultry farms and nearby clinics is a textbook One Health intervention.
• Delhi Declaration: The Delhi Declaration is the inter-ministerial commitment on antimicrobial resistance (AMR) signed in New Delhi on 19 April 2017 by the Union ministers for health and family welfare, environment, and consumer affairs. Adopted at the Inter-Ministerial Consultation on AMR Containment, it pledged a multi-ministry, One Health approach to fighting drug-resistant infections and endorsed India's National Action Plan on AMR (NAP-AMR). It remains a recurring reference point in India's AMR policy, cited in the successor NAP-AMR 2.0 for 2025-29. Example: The Declaration committed ministries spanning health, agriculture and animal husbandry to coordinated AMR surveillance, rational antibiotic use and infection control.
• Red Line campaign: The Red Line campaign, launched in February 2016 by the Union Ministry of Health and Family Welfare, fights antimicrobial resistance by marking prescription-only antibiotic packs with a vertical red line. The red line warns buyers that the medicine should be taken only on a doctor's prescription and that the full prescribed course must be completed. It targets the irrational use and over-the-counter sale of antibiotics, a major driver of drug-resistant infections. Example: Schedule H1 antibiotics carry the red line, signalling that self-medication with them risks breeding drug-resistant superbugs.
• ICMR AMR Surveillance Network: The ICMR AMR Surveillance Network, formally the Antimicrobial Resistance Surveillance and Research Network (AMRSN), tracks drug-resistant infections across India for the Indian Council of Medical Research. Established in 2013, it links nodal centres at premier medical institutions with regional laboratories in tertiary-care hospitals, collecting standardised resistance data through a real-time online system that feeds antibiotic policy and hospital stewardship. Example: Data from the network underpins India's National Action Plan on AMR 2.0 (2025 to 2029) and the Red Line campaign warning against antibiotic self-medication.
• vaccine: A vaccine is a biological preparation containing an antigen (a weakened or inactivated pathogen, a pathogen protein, or genetic material) that trains the immune system to recognise and fight a disease without causing the illness itself. When a vaccinated person later encounters the pathogen, memory cells mount a rapid antibody and cellular response that prevents or blunts infection; at high coverage this also protects the unvaccinated through herd immunity. Example: The oral polio vaccine used in India's pulse polio campaigns was central to the country achieving polio-free certification in 2014.
• antibodies: Antibodies, or immunoglobulins, are Y-shaped proteins produced by B lymphocytes of the immune system that recognise and bind to specific foreign molecules called antigens. Each antibody binds a particular antigen with high specificity, tagging pathogens and toxins for neutralisation or destruction by other immune cells. Beyond natural immunity, antibodies underpin vaccines, diagnostic tests like ELISA, and modern biologic drugs such as monoclonal antibodies used in cancer and autoimmune therapy. Example: Monoclonal antibodies such as trastuzumab target the HER2 protein on certain breast cancer cells.
• Inactivated vaccines: Inactivated vaccines are vaccines made from pathogens that have been killed, so they cannot cause disease but still train the immune system to recognise them. They are generally safe and stable but often need booster doses, and they sit alongside live-attenuated, viral vector and nucleic acid (mRNA or DNA) vaccine platforms. Example: Bharat Biotech's Covaxin and the injectable polio vaccine are inactivated vaccines.
• Live-attenuated vaccines: Vaccines made from pathogens that have been weakened in the laboratory so they can replicate in the body and provoke a strong, long-lasting immune response without causing the disease itself. They typically produce robust immunity, sometimes from a single dose, but are generally not given to people with severely weakened immune systems because of a small risk the pathogen could revert. Example: The BCG vaccine against tuberculosis, the oral polio vaccine, MMR (measles, mumps, rubella) and the yellow fever vaccine are all live-attenuated vaccines.
• Viral vector vaccines: Viral vector vaccines are vaccines that use a harmless, modified virus (the vector) to carry genetic instructions for a pathogen's protein into human cells, prompting the immune system to recognise and fight the real pathogen. They produce strong cellular and antibody responses and are relatively quick to develop, but pre existing immunity to the vector virus can reduce their effectiveness. They were a major platform in the COVID-19 response. Example: Covishield, the Oxford AstraZeneca COVID-19 vaccine manufactured in India by the Serum Institute of India, uses a chimpanzee adenovirus vector carrying the coronavirus spike protein gene.
• nucleic acid vaccines: Nucleic acid vaccines use genetic material, DNA or messenger RNA, instead of a weakened or killed pathogen, instructing the body's own cells to produce a pathogen protein that triggers an immune response. DNA vaccines use engineered plasmids while mRNA vaccines use lipid-encapsulated RNA; both platforms can be designed and manufactured faster than conventional vaccines. They need no live virus handling, which simplifies production. Example: ZyCoV-D, the world's first DNA vaccine for human use, developed in India and granted emergency use authorisation in August 2021.
• COVAXIN: COVAXIN is India's first indigenously developed COVID-19 vaccine, created by Bharat Biotech in collaboration with the Indian Council of Medical Research and the National Institute of Virology. It is a whole-virion inactivated vaccine, meaning it uses a killed SARS-CoV-2 virus to trigger immunity without causing disease, and it can be stored at ordinary refrigerator temperatures of 2 to 8 degrees Celsius. It received WHO emergency use listing in November 2021 and was a backbone of India's vaccination drive. Example: COVAXIN was exported to countries like Paraguay and Botswana during the pandemic under India's Vaccine Maitri initiative.
• ZyCoV-D: ZyCoV-D is the world's first plasmid DNA vaccine approved for human use, developed by Ahmedabad-based Zydus Cadila with support from India's Department of Biotechnology and ICMR, receiving emergency use authorisation from the DCGI in August 2021. A circular piece of DNA encoding the coronavirus spike protein is delivered into skin cells, which then produce the spike protein and trigger an immune response; it is given in three doses on days 0, 28 and 56 via a painless needle-free intradermal injector. It was also the first COVID-19 vaccine authorised in India for adolescents aged 12 to 18. Example: Because DNA vaccines are temperature-stable, ZyCoV-D demonstrated the plug-and-play DNA platform that can be adapted quickly to viral mutations.
• GEMCOVAC-OM: GEMCOVAC-OM is India's first Omicron-specific mRNA booster vaccine against COVID-19, developed by Pune-based Gennova Biopharmaceuticals with support from the Department of Biotechnology and BIRAC under Mission COVID Suraksha. It is thermostable, remaining stable at 2 to 8 degrees Celsius, so it avoids the ultra-cold chain that other mRNA vaccines need, and it is delivered intradermally through a needle-free device. It received emergency use authorisation from the Drugs Controller General of India. Example: It was granted emergency use authorisation as a booster for adults aged 18 and above who had completed primary vaccination with Covishield or Covaxin.
• CERVAVAC: India's first indigenously developed quadrivalent human papillomavirus (HPV) vaccine, launched by the Serum Institute of India in January 2023. Developed with the Department of Biotechnology and BIRAC, it protects against the HPV strains that cause most cervical cancers and is far cheaper than imported vaccines. It supports India's plan to vaccinate adolescent girls against cervical cancer. Example: CERVAVAC targets HPV types 16 and 18, which cause the large majority of cervical cancers, along with types 6 and 11.
• HPV vaccine: The HPV vaccine protects against infection by human papillomavirus, which causes nearly all cervical cancers as well as some other genital cancers. The World Health Organization recommends vaccinating girls aged 9 to 14, before sexual debut, for maximum effectiveness. India's Cervavac, developed by the Serum Institute of India and launched in January 2023, is the country's first indigenous quadrivalent HPV vaccine and a far cheaper alternative to imported vaccines. Example: Cervavac, launched in January 2023, made India one of the few countries producing its own HPV vaccine against cervical cancer.
• Co-WIN: Co-WIN (COVID Vaccine Intelligence Network) is India's digital platform for COVID-19 vaccination, launched on 16 January 2021 by the Ministry of Health and Family Welfare. It handles beneficiary registration, appointment scheduling, cold-chain logistics tracking and reporting of adverse events, and it issues digitally verifiable vaccination certificates with QR codes. Built as a cloud-based, open-architecture system, it supported the administration of over two billion vaccine doses, making it one of the world's largest digital health initiatives. Example: Co-WIN's digitally verifiable certificates, downloadable via the portal, Aarogya Setu and DigiLocker, served as vaccine passports for international travel.
• Drug-sensitive TB: Drug-sensitive tuberculosis is TB that responds to the standard first-line anti-TB drugs, including isoniazid and rifampicin, and is confirmed by tests showing no resistance in the infecting Mycobacterium tuberculosis strain. It is curable with the standard six-month regimen of antibiotics, provided the full course is completed without interruption. Stopping treatment midway risks turning drug-sensitive TB into drug-resistant TB. Example: A patient whose sputum sample shows susceptibility to rifampicin and isoniazid is treated under the standard drug-sensitive TB regimen rather than the longer MDR-TB protocol.
• Nikshay Poshan Yojana: A Direct Benefit Transfer scheme under the National Tuberculosis Elimination Programme, launched on 1 April 2018, that pays nutritional support money directly into the bank accounts of notified TB patients for the duration of their treatment. The monthly assistance was Rs 500 at launch and was doubled to Rs 1,000 with effect from November 2024, and the money is meant to help patients afford the nutrition essential for recovery. Example: The government has reported disbursing over Rs 4,300 crore to about 1.35 crore TB patients under the scheme since 2018.
• 100-day accelerated TB campaign: The intensified phase of the TB-Mukt Bharat Abhiyaan run by the Health Ministry from 7 December 2024 to 24 March 2025 (World TB Day) in 455 high-priority districts across 33 states and Union Territories. It used door-to-door screening, handheld X-ray devices and Ni-kshay Shivirs to detect missing TB cases, including asymptomatic ones, in support of India's goal of ending TB by 2025, five years ahead of the global SDG target. Example: the campaign screened 12.97 crore vulnerable people and notified 7.19 lakh TB patients, of whom 2.85 lakh were asymptomatic. Example: Screened 12.97 crore vulnerable people and notified 7.19 lakh TB patients, of whom 2.85 lakh were asymptomatic.
• bedaquiline: Bedaquiline is a diarylquinoline anti-tuberculosis drug with a novel mechanism: it blocks the mycobacterial ATP synthase enzyme, starving Mycobacterium tuberculosis of the energy it needs to survive. Developed by Janssen, it received US FDA approval in 2012 as the first new drug class for multidrug-resistant TB in over four decades, and WHO now prioritises it in shorter all-oral MDR-TB regimens. India incorporated bedaquiline into its revised national TB treatment guidelines, making it central to the country's TB elimination strategy. Example: India's National TB Elimination Programme uses bedaquiline-based all-oral regimens for patients with drug-resistant TB.
• delamanid: A newer anti-tuberculosis drug (marketed as Deltyba) developed specifically for multidrug-resistant TB, used as part of all-oral regimens that spare patients the painful daily injectables of older treatment. It belongs to the nitroimidazole class and inhibits mycolic acid synthesis in the TB bacterium. India introduced it under the National TB Elimination Programme for drug-resistant patients, including children, as part of the push to end TB. Example: India's Central TB Division rolled out delamanid from September 2018 in seven states for drug-resistant TB patients, later expanding access to children.
• BPaLM regimen: The BPaLM regimen is a six-month, all-oral treatment regimen for multidrug-resistant and rifampicin-resistant tuberculosis (MDR/RR-TB) recommended by the World Health Organization in its 2022 treatment guidelines. It combines four drugs, bedaquiline, pretomanid, linezolid and moxifloxacin (the initials give the name), replacing older regimens that lasted 9 to 18 months and often included painful injectables. Trials such as TB-PRACTECAL showed cure rates near 89 percent, making it the preferred option for most MDR/RR-TB patients and a major milestone in the fight to end TB. Example: WHO's 2022 guidelines made the 6-month BPaLM regimen the treatment of choice for most patients with MDR/RR-TB, replacing regimens that lasted up to 18 months.
• VPM1002: VPM1002 is a live recombinant tuberculosis vaccine candidate created by genetically modifying the century old BCG vaccine to improve its protection. It was originally developed in Germany and licensed to the Serum Institute of India, which has tested it in large Indian Phase III trials. India is the world's largest TB burden country, and a more effective TB vaccine is central to the national goal of eliminating tuberculosis. Example: The ICMR sponsored PreVenTB Phase III trial tested VPM1002 alongside the Immuvac candidate in over 12,700 participants across 18 sites in six Indian states.
• MIP: Mycobacterium indicus pranii, an atypical mycobacterium developed by G.P. Talwar's team in India as an immunotherapeutic vaccine. Used as an adjunct to multidrug therapy, it accelerates bacterial clearance and lepromin conversion in leprosy patients. It was also shortlisted by ICMR for Phase III trials as a tuberculosis vaccine candidate. Example: Field trials of the MIP vaccine were conducted in Kanpur Dehat, testing its ability to protect household contacts of leprosy patients.
• Ni-kshay 2.0 portal: The digital platform of the Pradhan Mantri TB Mukt Bharat Abhiyaan, also called Ni-kshay 2.0, launched by the President of India in September 2022 with the slogan TB Harega, Desh Jitega. It extends the original Ni-kshay TB surveillance portal by enabling tracking of TB patients and coordinating community support, as part of India's goal of eliminating tuberculosis by 2025, five years ahead of the global target. Example: Ni-kshay Mitras register on the portal to adopt TB patients and provide them with nutritional and diagnostic support.
• TB Mukt Panchayat: TB Mukt Panchayat is an initiative launched by the Prime Minister on World TB Day, 24 March 2023, at Varanasi to drive tuberculosis elimination from the grassroots. It empowers panchayati raj institutions to track and address TB in their villages, with panchayats earning bronze, silver or gold certification for sustaining TB-free status for one, two or three years. Example: A panchayat that maintains TB-free status for one year earns bronze certification under the initiative.
• Ni-kshay Mitra: An individual, institution, NGO or corporate body that voluntarily adopts one or more tuberculosis patients under the Pradhan Mantri TB Mukt Bharat Abhiyaan to provide extra support during treatment. Mitras typically supply monthly food baskets and may also help with diagnostics and vocational support, supplementing the free treatment and cash assistance the government provides. Example: Since September 2022, Ni-kshay Mitras have distributed over 45 lakh food baskets to more than 20 lakh TB patients, according to the government.
• Stem cell therapy: Stem cell therapy is a medical treatment that uses stem cells to repair, replace or regenerate damaged tissues. Because stem cells can differentiate into specialised cell types and self-renew, the therapy is used for conditions such as blood cancers (through bone marrow transplants) and is being developed for cartilage repair, spinal injuries and degenerative diseases. Example: Bone marrow transplant for leukaemia is the most established form of stem cell therapy.
• stem cells: Stem cells are undifferentiated cells that can divide to make more stem cells and can also specialise into specific cell types such as muscle, nerve, or blood cells. They are classified by potency: embryonic stem cells are pluripotent, while adult tissue-specific stem cells are usually multipotent. Their ability to regenerate tissue makes them central to regenerative medicine and to treating diseases such as leukaemia through bone-marrow transplants. Example: Hematopoietic stem cell transplants (bone marrow transplants) are routinely used to treat blood cancers and thalassemia.
• Embryonic stem cells: Embryonic stem cells are pluripotent cells taken from the inner cell mass of a blastocyst, an early-stage embryo about five days after fertilisation. Because they can differentiate into almost any cell type in the human body, they hold promise for regenerative medicine, such as growing insulin-producing cells for diabetes or neurons for spinal injury. Their use is ethically debated because harvesting them destroys the embryo, which is why many countries regulate or restrict such research. Example: Researchers differentiate embryonic stem cells into retinal cells in trials aimed at treating degenerative blindness.
• pluripotent: Pluripotent cells are stem cells that can develop into almost any cell type of the body, though not the placenta and supporting tissues. The main natural examples are embryonic stem cells, while induced pluripotent stem cells are created in the laboratory by reprogramming adult cells. Their ability to become neurons, heart muscle or blood cells makes them the foundation of regenerative medicine research. Example: Shinya Yamanaka's 2006 reprogramming of adult skin cells into induced pluripotent stem cells, for which he shared the 2012 Nobel Prize in Physiology or Medicine.
• Adult stem cells: Adult stem cells are undifferentiated cells found in mature tissues such as bone marrow, skin, and the brain, which can divide to renew themselves and differentiate into the specialized cell types of their home tissue. Unlike embryonic stem cells, their differentiation potential is limited, but they carry fewer ethical concerns and a lower risk of tumour formation. They are central to regenerative medicine because they can be harvested from the patient, avoiding immune rejection. Example: Hematopoietic stem cells from bone marrow or peripheral blood are routinely used in bone marrow transplants to treat blood cancers like leukaemia and lymphoma.
• multipotent: Multipotent describes stem cells that can develop into multiple cell types, but only within a limited family of related tissues. They sit between pluripotent embryonic stem cells, which can become any cell type, and fully specialised cells. Adult stem cells are typically multipotent, which makes them safer for therapy than pluripotent cells because they are less likely to form tumours. Example: Hematopoietic stem cells in bone marrow are multipotent: they cannot become brain or skin cells, but they can produce all blood cell types, which is why bone marrow transplants cure blood disorders like leukaemia.
• Mesenchymal stem cells: Multipotent adult stem cells found in bone marrow, adipose tissue, umbilical cord and other tissues, capable of differentiating into bone, cartilage and fat cells. Beyond regeneration, they modulate immune responses, which makes them candidates for treating inflammatory and degenerative conditions. They are among the most widely used cell types in clinical trials of regenerative medicine. Example: Mesenchymal stem cell therapies are being trialled for osteoarthritis, spinal injuries and graft-versus-host disease.
• ICMR Stem Cell Registry: The ICMR Stem Cell Registry is the national registry maintained by the Indian Council of Medical Research that tracks stem cell clinical trials in India. It brings transparency to a field governed by the National Guidelines for Stem Cell Research (ICMR-DBT, 2017), under which stem cell products are legally classified as drugs, helping regulators separate genuine trials from unproven clinics selling miracle cures. Example: Stempeucel, the first Indian stem cell product to win limited CDSCO manufacturing approval for critical limb ischemia, moved through this regulated pathway.
• Stempeucel: Stempeucel is India's first allogeneic cell therapy product, developed by the Bengaluru-based Stempeutics. It is an off-the-shelf product based on pooled mesenchymal stromal cells derived from the bone marrow of healthy adult donors. The Drug Controller General of India granted it manufacturing and marketing approval in August 2020 for critical limb ischemia, and it is also approved for knee osteoarthritis, marketed in India by Alkem as StemOne. Example: StemOne, built on Stempeucel technology, is prescribed for Grade II and Grade III knee osteoarthritis as an alternative to knee replacement.
• Digital health: Digital health is the use of digital technologies, from electronic health records and telemedicine to AI diagnostics and health apps, to deliver and manage healthcare. In India it is anchored by the Ayushman Bharat Digital Mission (ABDM), launched in September 2021, which builds a national digital health ecosystem of verified registries, health IDs (ABHA) and interoperable health records shared with patient consent. The goal is paperless, portable health records and wider access to care, especially through telemedicine in rural areas. Example: A patient's ABHA health ID lets a hospital in another state pull up their past prescriptions and lab reports with consent.
• ABHA: The Ayushman Bharat Health Account is a 14-digit unique health identifier issued under the Ayushman Bharat Digital Mission. It lets an individual link prescriptions, lab reports and discharge summaries across hospitals and clinics, so records travel with the patient and can be shared with providers through consent-based digital exchange. For UPSC it is the identity layer of India's digital health stack and a standard example of technology-enabled, portable healthcare. Example: a patient's prescriptions and lab reports accessible to any empanelled hospital through consent-based sharing
• e-Sanjeevani: e-Sanjeevani is the national telemedicine platform of the Ministry of Health and Family Welfare, described as the world's largest telemedicine deployment in primary healthcare. It has two variants: eSanjeevani AB-HWC, a doctor-to-doctor service linking Health and Wellness Centres (spokes) with specialist hubs, and eSanjeevaniOPD, a patient-to-doctor service scaled up during the COVID-19 pandemic. It crossed 10 crore teleconsultations by early 2023, with a majority of beneficiaries being women, and is a pillar of India's digital health ecosystem. Example: A patient at a rural Health and Wellness Centre consulting a specialist at a district hospital hub through a paramedic-assisted video call, with an e-prescription issued at the end of the session.
• e-Hospital: e-Hospital is a cloud-based Hospital Management Information System developed by the National Informatics Centre (NIC) under the Digital India programme. Its modules cover the full hospital workflow: patient registration, OPD and IPD management, billing, laboratories, pharmacy, blood banks and electronic medical records, and it is compliant with the Ayushman Bharat Digital Mission and ABHA health IDs. Its Online Registration System (ORS) lets patients book hospital appointments online instead of queuing at counters. Example: A patient booking an OPD appointment at a government hospital through the ORS portal and receiving lab reports digitally, without standing in registration queues.
• CoWIN: CoWIN is the Government of India's web portal for COVID-19 vaccination registration and certification, owned and operated by the Ministry of Health and Family Welfare. Citizens register with a mobile number and an approved ID, book vaccination slots at nearby public or private centres, and download vaccination certificates after each dose. Its five modules cover orchestration, the vaccine cold chain, citizen registration, vaccinator session management, and certification with feedback and adverse-event reporting. Example: India offered CoWIN as a digital public good to other countries in 2021, showcasing it as a replicable model for large-scale vaccination delivery.
• digital divide: The digital divide is the gap between those with access to digital technology, connectivity, and digital literacy and those without it, split along income, gender, rural-urban, and regional lines. In India it conditions the reach of Digital India, online education, UPI payments, and direct benefit transfers. For UPSC it is a GS-2 governance issue of equity in a digitising state.
• algorithmic bias: Algorithmic bias is the systematic and unfair skew in the outputs of an AI or machine-learning system, typically because its training data reflected historical prejudices or was unrepresentative of some groups. Because models learn patterns from data, they can amplify discrimination in hiring, lending, policing or medical diagnosis even when no explicit bias is coded. The concern is central to AI governance debates and to calls for data representativeness, bias audits and transparency in high-stakes AI deployments. Example: Facial recognition systems have been shown to misidentify darker-skinned faces at higher rates because training datasets were dominated by lighter-skinned faces.
• World Health Organization: The World Health Organization (WHO) is a specialised agency of the United Nations responsible for international public health, headquartered in Geneva with 194 member states. Founded when its constitution came into force on 7 April 1948 (observed as World Health Day), it sets global health norms and standards, coordinates responses to epidemics and pandemics, monitors disease outbreaks, and supports countries in building health systems. Its constitution defines health as a state of complete physical, mental and social well-being, not merely the absence of disease. Example: WHO coordinated the global COVID-19 pandemic response and leads the ongoing effort to eradicate polio.
• traditional medicine: Traditional medicine is the body of health practices, knowledge, and beliefs based on the theories and experiences of indigenous cultures, used to maintain health and treat illness. India's systems include Ayurveda, Yoga, Unani, Siddha, and Homoeopathy, collectively known as AYUSH, which rely largely on plant-based formulations. WHO recognises traditional medicine's role in primary health care, and India has pushed for its scientific validation and global standardisation. Example: The Traditional Knowledge Digital Library (TKDL) documents Indian medicinal formulations to prevent biopiracy, and it was used to get a US patent on turmeric's wound-healing use revoked.
• AYUSH: AYUSH stands for Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homoeopathy, India's recognised traditional systems of medicine. A dedicated Ministry of AYUSH was created in 2014 to regulate education, standardise practice and fund research, while the National AYUSH Mission mainstreams these systems into public healthcare alongside allopathy. UPSC examines AYUSH in health policy, integrative medicine, clinical-trial standards and India's wellness and traditional-medicine diplomacy. Example: the National AYUSH Mission co-locating AYUSH facilities in primary health centres
• Ministry of AYUSH: The Ministry of AYUSH is the Government of India ministry responsible for developing, regulating, and promoting the country's traditional and complementary systems of medicine: Ayurveda, Yoga and Naturopathy, Unani, Siddha, Sowa-Rigpa, and Homoeopathy (the initials spell AYUSH). It was formed in November 2014 by upgrading the earlier Department of AYUSH, signalling a policy push to integrate traditional medicine into public healthcare, research, and education. It also promotes these systems internationally. Example: The Ministry promotes the International Day of Yoga, observed on 21 June every year since 2015 under a UN resolution proposed by India.
• National Ayush Mission: The National Ayush Mission is a centrally sponsored scheme launched in 2014-15 by the Ministry of Ayush to promote Ayurveda, Yoga, Unani, Siddha, Sowa Rigpa and Homoeopathy. It funds the upgradation of Ayush hospitals and dispensaries, supply of medicines, cultivation of medicinal plants and quality improvement in Ayush education. The mission gives India's traditional systems of medicine a structured role in mainstream public health delivery. Example: Ayush health and wellness centres supported by the mission provide preventive and promotive care alongside modern medicine.
• Ayush-64: Ayush-64 is a polyherbal Ayurvedic formulation developed by the Central Council for Research in Ayurvedic Sciences (CCRAS) under the Ministry of AYUSH. Originally developed in 1980 for the management of malaria, it was repurposed in 2021 as an adjunct to standard care for asymptomatic, mild and moderate COVID-19 after studies suggested antiviral, immunomodulatory and antipyretic properties. It illustrates how traditional medicine formulations are evaluated through modern clinical trials for new therapeutic uses. Example: During the COVID-19 pandemic, Ayush-64 tablets were distributed free of cost to eligible mild and moderate patients at designated AYUSH centres in Delhi.
• AYUSH Export Promotion Council: The nodal Export Promotion Council for India's traditional medicine sector, set up by the Ministry of Ayush with support from the Ministry of Commerce and Industry and launched by the Prime Minister at the Global Ayush Investment and Innovation Summit in Gandhinagar on 20 April 2022. Known as AYUSHEXCIL, it promotes exports of Ayurveda, Yoga and Naturopathy, Unani, Siddha, Sowa-Rigpa and Homoeopathy products and services and addresses trade barriers abroad. Example: it anchors the Ayush Quality Mark programme that certifies the quality of exported Ayush products. Example: AYUSHEXCIL, launched 20 April 2022 at Gandhinagar, anchors the Ayush Quality Mark for exported traditional-medicine products.
• Pharmacopoeia Commission for Indian Medicine and Homoeopathy: The Pharmacopoeia Commission for Indian Medicine and Homoeopathy (PCIM&H) is the body under the Ministry of AYUSH that develops official quality standards, monographs and formularies for Ayurveda, Siddha, Unani and Homoeopathy drugs. First set up as an autonomous body in 2010, it was re-established as a subordinate office of the Ministry in 2020 by merging it with the Pharmacopoeia Laboratory for Indian Medicine and the Homoeopathic Pharmacopoeia Laboratory, both at Ghaziabad. Example: PCIM&H's published pharmacopoeial monographs define the identity, purity and strength tests that Ayurvedic, Siddha, Unani and Homoeopathy medicines must meet.
• diethylene glycol: A toxic industrial solvent and antifreeze agent that has repeatedly contaminated cough syrups when substituted, deliberately or through poor quality control, for pharmaceutical-grade glycerin or propylene glycol. Even small amounts can cause acute kidney injury, neurological damage and death, especially in children. It should never be present in medicines, and its presence signals a failure of raw-material testing. Example: In 2022 the WHO linked diethylene glycol contamination in Indian-made cough syrups to 66 child deaths in The Gambia, with further deaths in Uzbekistan and Indonesia.
• Drugs Controller General of India: The Drugs Controller General of India (DCGI) is the head of the Central Drugs Standard Control Organisation (CDSCO) and the apex authority for regulating drugs, medical devices and cosmetics in India. The DCGI approves new drugs for manufacture and marketing, grants permission for clinical trials, regulates vaccine and blood-product approvals, and issues import licences for pharmaceuticals. The office also oversees the national pharmacovigilance programme for adverse drug reactions. Example: The DCGI granted emergency use approval for COVID-19 vaccines in India before they could be rolled out commercially.
• State Drug Regulatory Authorities: State Drug Regulatory Authorities are the state-level bodies responsible for licensing drug manufacturing and sale premises and enforcing drug quality standards within their states. Under India's dual drug-regulation system, the Central Drugs Standard Control Organization (CDSCO) handles new-drug approvals and imports, while state authorities license manufacturing units, pharmacies and blood banks and monitor compliance with the Drugs and Cosmetics Act, 1940. Example: A state drug controller inspecting a pharmaceutical manufacturing unit for Good Manufacturing Practice compliance before renewing its licence.
• Drugs and Cosmetics Act of 1940: The Drugs and Cosmetics Act, 1940 is India's principal law regulating the import, manufacture, distribution and sale of drugs and cosmetics to ensure quality and safety. It prescribes statutory quality standards (through its Schedules), a licensing system for manufacturers and sellers, and penalties including imprisonment for offences such as manufacturing spurious, adulterated or misbranded drugs. It is implemented by the CDSCO at the Centre and state drug control authorities. Example: Selling a substandard antibiotic without a proper manufacturing licence draws prosecution under this Act.
• spurious: In drug regulation, 'spurious' refers to medicines that carry fake or counterfeit labels, a category defined under the Drugs and Cosmetics Act, 1940. Spurious drugs are unauthorised imitations of genuine brands, and they are distinct from 'not of standard quality' (NSQ) drugs, which simply miss manufacturing specifications. They pose a serious public health risk because patients cannot tell them apart from genuine medicines. Example: The WHO estimates that about 1 in 10 medical products in low- and middle-income countries is substandard or falsified.
• misbranded: A misbranded drug is one whose labelling or packaging is false or misleading, for instance carrying a fake brand name, hiding the true contents, or making exaggerated therapeutic claims. Under Section 17 of India's Drugs and Cosmetics Act, 1940, misbranded drugs are illegal alongside adulterated and spurious drugs, though the categories differ: counterfeit drugs carry fake labels, misbranded drugs mislead, and adulterated drugs are contaminated or substandard. Enforcement against misbranded and spurious drugs is a recurring public health challenge. Example: A cough syrup labelled as containing a premium imported active ingredient when it actually contains a cheaper substitute would be prosecuted as a misbranded drug under the Drugs and Cosmetics Act.
• adulterated: Adulterated, in drug regulation, describes a medicine that is contaminated, degraded or improperly made: it contains toxic or filthy substances, has been prepared under unsanitary conditions, or fails to meet prescribed standards of strength, quality or purity. Under India's Drugs and Cosmetics Act, 1940, adulteration is a serious offence, distinct from misbranded drugs, which merely mislead through false labelling. Regulatory inspections and quality testing of manufacturing plants exist precisely to catch adulterated batches before they reach patients. Example: A cough syrup contaminated with toxic diethylene glycol instead of safe glycerol would be classified as adulterated.
• Schedule M: Schedule M of the Drugs and Cosmetics Rules, 1945 lays down Good Manufacturing Practices (GMP) that pharmaceutical manufacturing premises in India must follow, covering factory premises, equipment, quality control and documentation. It was revised in 2023 to align Indian requirements with WHO-GMP standards, with phased implementation for smaller manufacturers. Compliance is a precondition for holding a manufacturing licence.
• Key takeaways: Key takeaways is a quick-revision summary box placed at the end of each article, listing the most exam-relevant points in a short numbered list. It distils definitions, dates, figures, provisions and examples into a form suited for last-minute revision before Prelims and Mains. Together with the article's practice questions, it turns every topic into a self-contained study unit.
• Drivers: In UPSC usage, drivers are the underlying forces or factors that propel a trend, such as the drivers of economic growth, urbanization, or climate change. Identifying drivers is a standard mains technique: it converts a descriptive question into an analytical one. It matters for UPSC because answers organized around the drivers of a phenomenon read as structured and score better than mere lists of facts.
• Way forward: In UPSC mains answers, essays and policy discussions, the way forward is the concluding section that moves from analysis to concrete, actionable recommendations for solving the problem discussed. A strong way forward is specific and implementable, naming institutions, reforms, technologies or timelines, rather than repeating generic calls for awareness. Examiners reward answers that end with a realistic, multi stakeholder roadmap instead of stopping at criticism. Example: A way forward on urban flooding could propose sponge city designs, strict protection of wetlands as natural sponges, and real time flood warning systems run by municipal corporations.
• failures: In UPSC usage, failures denotes the shortcomings or breakdowns of a policy, plan, movement or institution under discussion, such as the failure of a scheme to meet targets or of a strategy to achieve its aims. Analysing failures is a standard mains demand, requiring causes, evidence and lessons rather than mere description. It appears across GS papers wherever evaluation is asked.
• reforms: Reforms is the plural of reform, denoting a package of deliberate policy changes. In the Indian context it most often means the economic reforms begun in 1991: delicensing, trade opening, financial sector change, and privatisation. The word also covers administrative, judicial, and electoral reform agendas. It serves GS-2 and GS-3. Example: the 1991 LPG reforms under the Narasimha Rao government
• Promise: Promise is the upside case for digital health in India: ABDM and ABHA IDs, e-Sanjeevani's 20 crore consultations, IHIP disease surveillance and e-Hospital efficiency, which together can democratise healthcare. The article pairs it with the divide: the digital divide may deepen inequity, so the promise must be weighed against access gaps.
• Antimicrobial resistance (AMR): Antimicrobial resistance is the ability of bacteria, viruses, fungi, and parasites to survive medicines designed to kill them, making common infections harder and costlier to treat. It is accelerated by overuse and misuse of antibiotics in human medicine and livestock, poor infection control, and weak regulation of drug sales. The WHO ranks AMR among the top global health threats, and India faces a particularly high burden. Example: Extensively drug-resistant tuberculosis (XDR-TB) in India and the spread of the NDM-1 resistance gene illustrate why AMR is a national health security issue.
• National Action Plan on AMR 2.0 (2025-29): The National Action Plan on Antimicrobial Resistance 2.0 is India's updated five-year strategy (2025 to 2029) to combat antimicrobial resistance, launched by Union Health Minister J.P. Nadda in November 2025. It follows the first plan of 2017 and is built on the One Health approach, linking human health, animal health, food and the environment. It addresses gaps in the earlier plan by strengthening inter-sectoral coordination, laboratory surveillance, infection control and engagement with the private sector. Example: Kerala and Gujarat became the first states to ban over-the-counter sale of antibiotics, a step highlighted at the plan's launch.
• Universal Immunisation Programme: The Universal Immunisation Programme is India's national vaccination programme, launched in 1985, providing free vaccines against 12 vaccine-preventable diseases including tuberculosis, polio, measles, hepatitis B and rotavirus diarrhoea. It covers about 2.7 crore newborns and 3 crore pregnant women each year, making it one of the world's largest public health programmes. For UPSC, it anchors health and social justice questions. Example: Mission Indradhanush, launched in 2014 under UIP, targets unvaccinated and partially vaccinated children.
• Tuberculosis (TB): Tuberculosis is an infectious disease caused by the bacterium Mycobacterium tuberculosis, most commonly attacking the lungs and spreading through airborne droplets from coughing or sneezing. India carries the world's largest TB burden, and its National TB Elimination Programme targets ending TB by 2025, five years ahead of the global SDG deadline, using the Ni-kshay digital platform for patient tracking. Drug-resistant TB remains a major treatment challenge. Example: The BCG vaccine administered at birth, which protects young children against severe forms of TB.
• National TB Elimination Programme (NTEP): The National TB Elimination Programme is India's flagship programme against tuberculosis, previously known as the Revised National Tuberculosis Control Programme until its renaming in 2020. It provides free diagnosis and treatment, including the Nikshay digital platform for patient tracking and Nikshay Poshan Yojana, which gives direct benefit transfers to TB patients for nutrition. India has set the ambitious target of ending TB by 2025, five years ahead of the global SDG target of 2030. Example: A TB patient registered on Nikshay receives Rs 500 per month under Nikshay Poshan Yojana for nutritional support during treatment.
• Multidrug-resistant TB (MDR-TB): Multidrug-resistant tuberculosis is a form of TB caused by strains of Mycobacterium tuberculosis that do not respond to at least isoniazid and rifampicin, the two most powerful first-line anti-TB drugs. It arises mainly when patients receive inadequate, interrupted, or incorrect treatment, and it requires longer, costlier second-line regimens with more side effects. India carries one of the world's largest MDR-TB burdens, and rapid molecular tests such as CBNAAT are used for early detection. Example: India's National TB Elimination Programme provides free second-line drug regimens for drug-resistant TB under its programmatic management component.
• Extensively drug-resistant TB (XDR-TB): XDR-TB is a severe form of drug-resistant tuberculosis defined by WHO (2021) as TB caused by Mycobacterium tuberculosis strains that meet the MDR/RR-TB definition and are also resistant to any fluoroquinolone and at least one additional Group A drug (bedaquiline or linezolid). It is much harder and more expensive to treat than ordinary TB, with longer regimens and higher toxicity risk. It typically develops from mismanaged TB treatment or spreads from an already ill patient through the air. Example: A patient whose TB strain resists rifampicin, isoniazid, moxifloxacin and bedaquiline would be classified as having XDR-TB.
• induced pluripotent stem cells (iPSCs): Induced pluripotent stem cells are adult cells, such as skin cells, that scientists have reprogrammed back into an embryo-like state in which they can develop into almost any cell type in the body. They are created by introducing a small set of genes, called Yamanaka factors, into ordinary cells. Because iPSCs come from the patient, they avoid both the ethical issues of embryonic stem cells and the risk of immune rejection. Example: iPSCs are used to grow patient-specific heart or nerve cells in the laboratory for disease modelling and drug testing.
• National Guidelines for Stem Cell Research (ICMR-DBT, 2017): The National Guidelines for Stem Cell Research, 2017 were jointly issued by the Indian Council of Medical Research and the Department of Biotechnology, replacing the 2013 guidelines. They set the ethical and regulatory framework for stem cell research and therapy in India, distinguishing between permissible basic research, research requiring review committee approval and prohibited activities such as reproductive cloning. The guidelines were framed to curb unproven stem cell therapies while supporting legitimate regenerative medicine research. Example: Any stem cell clinical trial in India must obtain institutional and national-level review committee approvals under these guidelines.
• Ayushman Bharat Digital Mission: The Ayushman Bharat Digital Mission, launched in September 2021, builds the digital backbone of India's health system on open, interoperable standards. Its building blocks include the Ayushman Bharat Health Account number for citizens, the Healthcare Professionals Registry and the Health Facility Registry, enabling consent-based sharing of digital health records across providers. It is a flagship UPSC example of digital public infrastructure applied to health. Example: Patients use their 14-digit ABHA number to link health records across different hospitals.
• Unified Health Interface: The Unified Health Interface is an open protocol under the Ayushman Bharat Digital Mission that enables interoperable digital health services across providers. It lets patients discover, book, and pay for services like teleconsultation across different apps and hospitals through a common network. For UPSC, it is the health-sector analogue of UPI and a key example of open digital public infrastructure. Example: A patient can book a teleconsultation with any empanelled hospital through any UHI-enabled app.
• Integrated Health Information Platform (IHIP): The next-generation digital disease surveillance platform launched by the Union Health Ministry on 5 April 2021 as the refined successor to the Integrated Disease Surveillance Programme (IDSP). It captures near-real-time, case-based data on 33 priority health conditions, up from 18 under IDSP, drawing reports from grassroots health workers, health facilities and diagnostic laboratories, with GIS-enabled dashboards for outbreak detection and response. Example: IHIP enables district and state officials to spot disease outbreaks in near-real time and trigger targeted public health action.
• WHO Global Centre for Traditional Medicine: The WHO Global Centre for Traditional Medicine at Jamnagar in Gujarat was established by the World Health Organization in 2022 with the support of the Government of India (Ministry of Ayush), and is WHO's first and only global outposted centre for traditional medicine. It serves as a knowledge hub for evidence-based traditional, complementary and integrative medicine, covering research and evidence, health systems, biodiversity and equity, and innovation and technology. Example: India committed about US$250 million and 35 acres of land for the centre's construction, which was inaugurated by Prime Minister Narendra Modi alongside WHO Director-General Tedros Adhanom Ghebreyesus.
• Central Drugs Standard Control Organisation (CDSCO): The Central Drugs Standard Control Organisation (CDSCO) is India's national drug regulator, functioning under the Directorate General of Health Services in the Ministry of Health and Family Welfare. Headed by the Drugs Controller General of India (DCGI), it approves new drugs and clinical trials, regulates drug imports, and lays down standards for drugs, cosmetics and medical devices under the Drugs and Cosmetics Act, 1940. State drug controllers handle manufacturing licences while CDSCO handles central approvals. Example: CDSCO granted emergency use authorisation to COVAXIN and Covishield during the COVID-19 pandemic in January 2021.
• not of standard quality (NSQ): In India's drug regulation, a medicine is declared Not of Standard Quality when laboratory testing shows it fails to meet the prescribed standards of identity, purity, or strength under the Drugs and Cosmetics Act. NSQ covers substandard medicines, such as tablets containing too little active ingredient or dissolving too slowly, and is distinct from spurious or counterfeit drugs. A finding of NSQ triggers regulatory action including recalls and action against the manufacturer. Example: The Central Drugs Standard Control Organisation publishes monthly lists of drug samples found NSQ after testing in government laboratories.
• mrna vaccine: An mRNA vaccine is a biological preparation that introduces a piece of messenger RNA corresponding to a viral protein, so the body's own cells manufacture the protein and the immune system learns to attack it. The mRNA does not enter the nucleus and does not alter the recipient's DNA.
• mitochondrial donation treatment: Mitochondrial donation treatment (MDT) is a specialised IVF technique designed to prevent the transmission of mitochondrial diseases from mother to child, using the parents' nuclear genetic material and a donor's healthy mitochondria.
• mitochondrial replacement therapy (mrt): Mitochondrial replacement therapy (MRT) is another name for mitochondrial donation treatment: an IVF technique in which faulty maternal mitochondria are replaced with a donor's healthy mitochondria so the child does not inherit mitochondrial disease.
• three-parent baby: A three-parent baby is a child born through mitochondrial donation treatment, carrying nuclear DNA from the mother and father plus a small amount of mitochondrial DNA, about 37 genes, from a female donor.
• graft-versus-host disease (gvhd): Graft-versus-host disease (GVHD) is a condition in which transplanted donor stem cells recognise the recipient's body as foreign and attack it, causing skin rash, diarrhoea and liver damage.
• autologous stem cell transplant: An autologous stem cell transplant uses the patient's own stem cells: they are collected from bone marrow or blood before a treatment that destroys blood cells, then re-infused to rebuild the blood system.
• allogeneic stem cell transplant: An allogeneic stem cell transplant uses stem cells donated by a matched donor's bone marrow or blood, given to the patient to rebuild the blood system. Its main risk is graft-versus-host disease.

Prelims practice