The 12th Dr. Ajay Khare Memorial Lecture held in Bhopal on March 7 highlighted the continuing challenges of hunger, tuberculosis and malnutrition in India, with public health experts stressing that these issues remain central to the country’s health crisis despite the availability of medicines and government programmes.
Delivering the memorial lecture, Dr. Sunil Kaul, a well-known public health expert, said that nearly 400,000 people continue to die of tuberculosis every year in India even though medicines for the disease are available free of cost. Referring to research conducted by Dr. Anurag Bhargava, he pointed to the scientifically established link between tuberculosis and hunger, noting that effective treatment requires not only medicines but also adequate and nutritious food. While earlier targets aimed to reduce TB deaths by 50 percent, he said the current reduction stands at only about 25 percent.
Dr. Kaul also highlighted the serious issue of malnutrition, particularly in Madhya Pradesh, and stressed the importance of nutrition and care during the first 1,000 days of life—from pregnancy to the first two years of a child’s development. He questioned whether the current Anganwadi model is sufficient to address the scale of the challenge and called for deeper discussions on strengthening early childhood nutrition programmes. Emphasising that saving lives through public health requires more than medical treatment alone, he said stronger investments are needed in nutrition, social security, education and equality.
The 12th Dr. Ajay Khare Memorial Lecture and the presentation of the Jan Swasthya Samman awards were organised in Bhopal by the Jan Swasthya Abhiyan Madhya Pradesh and the Madhya Pradesh Medical Officers Association in memory of noted public health expert Dr. Ajay Khare, who was closely associated with the people’s health and science movements.
On the occasion, the Jan Swasthya Samman 2025 awards were presented, the announcement of which was made by Dr. Anant Bhan. A Special Posthumous Jan Swasthya Samman was conferred upon the late Dr. C. M. Gulhati for his contributions to medicines and drug policy. The award also honoured senior public health expert Dr. C. Sathyamala for her outstanding work in public health. Public health and social activist Vivek Pawar was recognised for his contribution to addressing the social determinants of health.
Introducing the programme, Amulya Nidhi noted that over the past twelve years the lecture series has hosted several leading public health experts from across the country who have addressed major public health challenges. This year’s event also marked the presentation of the sixth National Jan Swasthya Samman.
In his lecture, Dr. Kaul emphasised that public health must not be confined to medical treatment alone but should be understood in the broader context of social justice, equality and living conditions. He warned that when politics deteriorates it inevitably affects public health, and remarked that increasing economic control over basic resources could have serious consequences. “If the idea of taxing water becomes acceptable, the day may not be far when air too may be taxed,” he said.
Dr. Kaul, a, former Army doctor, and founder of the Action Northeast Trust (ANT) in Assam, also expressed concern over the growing commercialisation of education and competitive examinations, citing the example of the National Eligibility cum Entrance Test (NEET), and said that the direction in which the system is moving reflects a worrying deviation. He further observed that a large portion of the national budget is allocated to the Home Ministry and defence while comparatively less investment is made in the social sector and public health.
Describing violence against women as a major public health crisis, Dr. Kaul cited government data indicating that around 35,000 women die each year due to dowry-related or domestic violence, often through burning, while non-governmental estimates suggest the number may be as high as 75,000. Referring to a survey conducted in Assam, he said that 58 percent of men admitted to committing some form of violence against their wives, underscoring that violence is a broader societal and public health concern rather than only a women’s issue.
He also pointed out that hate, caste discrimination and communal violence have profound impacts on public health. Referring to the framework of the Sustainable Development Goals, he noted that while the original vision of health systems was equal care for all, the reality increasingly shows that access to treatment becomes difficult without financial resources.
Dr. Kaul identified climate change as another emerging public health challenge, warning that Himalayan glaciers are melting rapidly and their size could significantly decline in the coming decades. “We can hope for the best, but we must prepare for the worst,” he said.
He advocated a decentralised health model and suggested that community health workers such as ASHA workers should receive additional training to provide medicines and basic primary care, thereby strengthening community-level health systems during crises. He also raised concerns about the pricing of medicines, saying that many drugs are sold at prices several times higher than their manufacturing costs, which contributes to inequalities in healthcare access.
In his presidential remarks, Dr. Rajneesh Joshi said that health outcomes are shaped by social behaviour and context and cannot be viewed only in terms of doctors, medicines and treatment. Education, empowerment, political will and poverty all influence health outcomes, he said, stressing that social determinants must remain central to public health efforts.
Representing the Madhya Pradesh Medical Officers Association and speaking in his capacity as Chief Medical and Health Officer of Indore, Dr. Madhav Hasani said that the work and vision of Dr. Ajay Khare must be carried forward collectively. Recalling his association with Dr. Khare, he said the organisation had consistently raised important public health issues in society. He added that recent developments in Indore underline the need to address not only treatment but also the broader social and environmental determinants of health.
The introduction of the keynote speaker was given by Rakesh Dewan, while Subhash Sharma, General Secretary of Vigyan Sabha, welcomed the chair of the programme. The event was moderated by Aarti Pandey and Dhirendra Arya. Guests were welcomed by Sudha Tiwari, Mohan Sulya and Azam Khan, and the vote of thanks was delivered by Ashish Pare.
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