India’s Health Ministry Faces Criticism Over Delayed Inclusion of Essential Medicines, Leaving Millions Unserved

Worksite Schools in Hyderabad: Economic Impact of Migrant Child Education

The Cyberabad police, Telangana Education Department and municipal authorities inaugurated a classroom inside the Rajapushpa labour camp in Narsingi on May 2024. The pilot, now serving 53 children from five states, is slated to be replicated in ≈ 100 labour camps across the city, signalling a new model of on‑site schooling for migrant families.

The scheme embeds a full‑day school within a construction site, where children receive instruction in English, Mathematics and Hindi from 8 a.m. to 5 p.m. Playtime, soft‑skill sessions and supervised breaks are built into the timetable, and meals are served on disposable plates by the students themselves.

• ▸The inaugural classroom opened in May 2024 at the Rajapushpa camp, housing 37 students initially.
• ▸Enrollment has risen to 53 students drawn from Bihar, Jharkhand, Odisha, Uttar Pradesh and Assam.
• ▸Two additional schools at Navanaami and BSR Developers sites are ready for inauguration.
• ▸The Commissionerate’s target is to establish schools in ≈ 100 labour camps across Cyberabad.
• ▸Each school day lasts nine hours, covering core subjects and extracurricular activities.

Economic rationale: Human capital and labour migration

Migrant construction workers constitute a fluid workforce that moves every few months in search of contracts. Their families live in temporary blue shelters, which hampers continuous schooling and depresses long‑term skill formation. By delivering education at the worksite, the programme seeks to preserve human capital that would otherwise be lost to migration cycles.

• ▸Families relocate every few months, disrupting children’s education and increasing dropout risk.
• ▸Temporary shelters lack basic amenities, limiting access to libraries or after‑school tutoring.
• ▸The nine‑hour school schedule aligns with workers’ shift patterns, reducing opportunity cost for parents.
• ▸Retaining children in school improves future labour‑force participation, a key driver of per‑capita income growth.
• ▸The model dovetails with the National Education Policy 2020’s emphasis on inclusive, location‑responsive schooling.

Health policy lag: The National List of Essential Medicines

While education gains a foothold, the health sector lags behind. The National List of Essential Medicines (NLEM) – the Ministry of Health and Family Welfare’s curated catalogue that guides the National Pharmaceutical Pricing Authority (NPPA) in setting price caps – has not been revised since 13 September 2022. The list currently enumerates 384 drugs, whereas the World Health Organization’s Model List has been updated twice (2023, 2025).

• ▸The last NLEM amendment was dated 13 September 2022, fixing the count at 384 medicines.
• ▸The WHO Model List was revised in 2023 and again in 2025, adding newer oncology and biologic therapies.
• ▸A Working Group on Access to Medicines wrote to the Centre on 3 July 2026 urging an urgent update.
• ▸Delay in inclusion means millions of patients cannot obtain free medicines under public‑sector schemes.
• ▸Price‑capped drugs under the NPPA reduce out‑of‑pocket expenditure, but the benefit is limited to medicines already on the NLEM.

The numbers that matter

Both initiatives illustrate how policy gaps translate into economic costs. The education model, by anchoring schools to construction sites, directly addresses the hidden cost of labour‑migration‑induced skill erosion. Conversely, the stagnant NLEM perpetuates higher health‑care spending, eroding household savings and widening fiscal pressure on the health budget.

• ▸53 students currently benefit from the Narsingi school; scaling to ≈ 100 camps could serve ≈ 5,000 children.
• ▸The construction workforce in Hyderabad exceeds 150,000 workers, implying a sizable pool of potential beneficiaries.
• ▸The NLEM’s 384‑medicine roster lags behind the WHO’s expanded list, which now exceeds 500 drugs.
• ▸Each price‑capped medicine can lower retail cost by up to 30 percent, according to NPPA guidelines (illustrative range).
• ▸Delayed inclusion of oncology and diabetes drugs leaves a treatment gap for high‑prevalence conditions, inflating private‑sector spend.

Significance and way forward

The worksite school experiment demonstrates that targeted public‑private collaboration can