How opportunities could turn into threats

India’s healthcare sector offers multiple opportunities, both at the individual, organisation and country level. But these opportunities could soon be subverted into threats. For instance, India’s doctors and nurses continue to be in global demand but this deepens the shortage of talent at home. The latest OECD International Migration Outlook 2025 report reveals that India tops the list of 25 main countries of origin for migrant doctors in the OECD, circa 2020/21, with a 76% growth since 2000/01. India is in the second spot when it comes to migrant nurses in the OECD circa 2020/21, with a whopping 435% growth since 2000/01. These percentage increases over two decades are concerning, given the huge doctor/nurse shortage in India.

The report recommends that one way to address this challenge is to combine bilateral agreements and training programmes to foster skills development in countries of origin while addressing skills shortages in destination countries. For instance, the UK has established government-to-government agreements with six countries, including India since July 2022, for health and social care workforce recruitment. In February 2024, Denmark and India signed a Mobility and Migration Partnership Agreement, which, among other things, explored the potential for recruiting qualified Indian professionals for employment in the Danish healthcare and medical services sector. The report also cites the Aurora project in Belgium, initiated by private stakeholders in 2021, which focuses on the recruitment and training of Indian nurses for the Flemish healthcare system. While these capacity building measures are welcome, will they actually promote the permanent migration of doctors and nurses? 

Policy makers do seem to be aware of the implications. In a written reply to a query during the ongoing winter session of parliament, Union Health Minister J P Nadda informed the House that the union government had set up 118 medical colleges in the country in the last two years, 74 medical colleges were approved in AY 2024–25 and 44 in AY 2025–26. Uttar Pradesh saw the highest number of new colleges across the two years, followed by Maharashtra and Rajasthan. India’s doctor-population ratio is currently estimated at 1:811, as per the minister’s reply. Nadda added that the number of medical colleges has risen from 387 to 818 since 2014, while UG seats have increased from 51,348 to 1,28,875 and PG seats from 31,185 to 82,059. 

In addition, the Union Cabinet has approved Phase-III of the Centrally Sponsored Scheme for strengthening and upgrading state and central government medical colleges and standalone PG institutes. This phase, which will run from 2025-26 to 2028-29, aims to add 5,000 PG seats and 5,023 MBBS seats, with an enhanced cost ceiling of Rs 1.50 crore per seat. 

Creating medical colleges and increasing the number of seats and students will increase the talent pipeline but how many of these students will stay back? The real policy changes need to be done within India, to train, retain and bring back doctors and nurses, so that they see a clear path of career progression, with commensurate returns. 

Another opportunity that could be subverted into a threat concerns the push to make India self-sufficient in medical devices. The December edition of The Aware Consumer (TAC), highlights a serious concern that medical devices manufactured in other countries, most notably China as per Prof Bejon Misra, Publisher and Editor, TAC, are being imported and deliberately misrepresented as designed and manufactured by an Indian company, while they are actually just repackaged and relabelled as ‘Made in India.’ In his editorial, Prof Misra recommends that instead of importing components or products and simply assembling or rebranding them as ‘Made in India’, the focus should be on bringing in technology, leveraging domestic raw materials and producing truly indigenous products. Otherwise, he warns that “India risks becoming nothing more than a dumping ground for outdated, expired – and even banned – products from around the world.”

Prof Prafull D Sheth cautions that such practices undermine the credibility of India’s ‘Make in India’ and ‘Atmanirbhar Bharat’ vision and weakens the trust of doctors and patients who rely on authenticity and safety.

There are also examples of regulatory directives that set out to do good but end up reinforcing the status quo. For instance, Rajiv Nath, Joint Managing Director of Hindustan Syringes & Medical Devices Ltd (HMD) and Forum Coordinator, Association of Indian Medical Device Industry (AiMeD), points out that while the CDSCO circular dated November 17, 2025, asserts that the basis of procurement of medical devices in public health tenders needs to be the CDSCO licensing criteria and buyers should not be seek manufacturers having overseas regulatory approvals of USFDA and CE. As he puts it, “We do not need to be seeking an international driving license from Indians to drive in India.”

However, while the November 17 circular makes CDSCO licensing mandatory, he points out that the last sentence in the November 17 circular, (‘any other certifications which is required by the procurement agency should be over and above of CDSCO or SLA) means that the circular still allows hospital and big buyers to specify CE/USFDA certification as a requirement along with the Indian license. He believes that it does not change the situation for Indian manufacturers as it allows a “weeding out” of Indian manufacturers during technical bids. In his opinion, Indian manufacturers remain in an unfair spot on this count and therefore the last line needs to be expunged/ edited.

India’s medical device sector is heavily (65%) import dependent hence there is ample space for a good balance between domestic and imported medical devices and technology. 

Let us hope that 2026 will bring a better balance in healthcare policy making and execution priorities.

VIVEKA ROYCHOWDHURY, Editor
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