Kerala: Dust-ups over recruitments and generic drugs

Kerala governor Rajendra Arlekar’s parting shot is more than a confrontation with the UDF government. On 15 October, just before leaving to take charge as governor of Tamil Nadu, Arlekar recommended the removal of Public Service Commission (PSC) chairman M.R. Baiju and all 15 members.

The timing is significant. The crime branch was investigating recruitment-related complaints against the PSC leadership appointed under the previous Pinarayi Vijayan government. Allegations of examination irregularities, questionable selection procedures and appointments had seriously damaged the commission’s credibility.

By recommending the removal of the entire leadership without consulting or informing the elected government, a genuine crisis of confidence in a constitutional institution risks becoming an opportunity for the Sangh Parivar to expand its influence over public recruitment in Kerala.

The Planning Board recruitment controversy illustrates the seriousness of the allegations. In an economics examination involving 228 answer scripts, Q. 9 was not evaluated in 177 papers, while Qs 10-18 were left unevaluated or not properly assigned for evaluation across all 228 papers.

Rank lists were prepared and appointments made on the basis of these assessments. The irregularities came to light after a candidate obtained his answer sheet through the Right to Information Act. The investigation and complaints concerning other recruitments placed the PSC’s functioning under a cloud.

The previous government’s nominees cannot escape accountability. Every substantiated allegation must be investigated, and those responsible must face appropriate action. But using these failures to justify a sweeping intervention without establishing its constitutional basis creates a dangerous precedent. A compromised commission does not give the governor unrestricted authority.

Articles 315 and 316 provide for Public Service Commissions and govern their composition and appointments. Article 317 prescribes safeguards for removing a chairman or member, including a Supreme Court inquiry into alleged misbehaviour.

Arlekar’s recommendation alone is not enough. The President’s response must comply with the Constitution.

These safeguards exist to prevent public recruitment from becoming vulnerable to the political preferences of those occupying constitutional offices.

The larger concern is the Sangh Parivar’s expanding ambitions in Kerala. The PSC is not an ordinary government department. Access to public employment is a vital route to social mobility for working-class families and disadvantaged communities.

Political influence over recruitment can have consequences extending far beyond individual appointments. Replacing one compromised arrangement with another would not be reform; it would merely change the beneficiaries of political patronage.

The Congress-led UDF government faces a difficult test. It must cooperate with legitimate investigations, expose entrenched malpractice and introduce transparent procedures to restore public confidence. It cannot defend the previous government’s nominees simply to oppose the exiting governor. Equally, it must not allow previous failures to become a pretext for the Sangh Parivar to appropriate the commission.

By using recruitment irregularities under the previous Pinarayi Vijayan government’s nominees to justify a sweeping intervention, Rajendra Arlekar has opened a dangerous front in Kerala’s struggle to protect public institutions from political appropriation. The UDF government must clean up the recruitment system without surrendering the PSC to a Sangh Parivar game plan.

Politics mars a public health breakthrough

A medicine that costs more than Rs 5 lakh a bottle could be available to Kerala’s public health system for around Rs 8,000. Switching to this affordable Indian generic could save the state crores of rupees and make treatment for children with spinal muscular atrophy (SMA) more sustainable.

Yet Kerala’s CPI(M) leaders — the Left has a historic commitment to affordable medicines — have turned the decision by the Congress government into a controversy over drug safety.

Risdiplam is used to treat SMA, a rare genetic disorder that progressively weakens muscles and can, in severe cases, be fatal. Swiss pharma major Roche’s branded medicine, Evrysdi, is prohibitively expensive. Natco Pharma’s Indian generic, Natsmart, contains the same active pharmaceutical ingredient and has received regulatory approval.

Kerala’s SMA technical committee estimates that switching to the generic could reduce the state’s annual expenditure for 129 children from around Rs 25 crore to Rs 25 lakh. The move can be replicated in other states.

State health minister K. Muraleedharan has defended the decision, emphasising that it followed expert recommendations and regulatory clearance. The Central Drugs Standard Control Organisation clarified that separate bio-equivalence studies and additional clinical trials were not required for this oral solution under the applicable regulatory guidance. Delhi High Court rejected Roche’s challenge to manufacturing the generic and the Supreme Court declined to overturn that outcome.

The scientific and regulatory position is therefore clear on a crucial point: Natsmart is an approved generic formulation, not an experimental drug awaiting clinical trials. The Indian Medical Association has also weighed in, with its Kerala president, Dr N. Sulphi, describing the controversy as a fallout of competition between pharmaceutical companies rather than evidence that the generic is unsafe.

While the head of Kerala’s SMA technical committee, Dr K.V. Viswanathan, has defended the medicine’s regulatory status and suitability, interventions by Dr B. Iqbal and Dr V. Ramankutty have given the debate an additional political dimension.

Iqbal, a public health activist associated with the Left, has welcomed the move towards affordable generic treatment. Ramankutty, a paediatrician, epidemiologist and former professor at the Achutha Menon Centre for Health Science Studies in Thiruvananthapuram, recalled his participation in Left-led campaigns for cheaper generic medicines in the 1980s. He expressed surprise at the Left questioning a regulator-approved generic.

Their criticism carries weight because it comes from within the progressive public health movement, not from the UDF government. They argue that the price of medicine cannot be divorced from the question of who gets access to treatment.

The political contradiction is sharpened by the previous LDF government’s own record. An expert committee constituted under former health minister Veena George initiated discussions on procuring Natco’s generic medicine and subsequently recommended the switch after seeking regulatory clarification. The committee’s minutes recorded that the drug had received marketing approval and separate studies were not required.

Against this background, Leader of the Opposition Pinarayi Vijayan and former health ministers P.K. Sreemathy, K.K. Shailaja and George raised alarms over bottles labelled ‘Physician Sample’ and ‘For Clinical Trials Only’, suggesting that children might have been exposed to experimental medicine. The manufacturer has said the disputed bottles came from its patient assistance programme. Hospital authorities retrieved the stock after concerns emerged.

The labels understandably caused concern, but they do not establish that the approved drug itself was undergoing clinical trials. The government must explain the labelling and ensure that families receive clear information. But political leaders also have a responsibility to verify regulatory facts and consult relevant experts before amplifying claims that could frighten parents away from an approved medicine.

Kerala’s generic SMA initiative deserves scrutiny, not misinformation. The real public health test is whether the state can protect children while breaking the grip of prohibitive drug prices. For families confronting a rare and devastating disease, affordable treatment is not a political slogan. It is a lifeline.