“I Couldn’t Breathe”: Inside the Crisis at Jan Aushadhi Kendras
What if the medicine that’s meant to save your life stops working—because it did not go through proper quality control measures and was not good enough to begin with? Across India, patients are walking into Jan Aushadhi Kendras seeking affordable relief. While the scheme is good in parts a large number of people walk out with broken trust, expired pills, and sometimes, no medicine at all. Touted as a healthcare revolution, the scheme is now cracking under the weight of substandard drugs, regulatory blind spots, and a growing crisis of confidence. This story is about policy failure, this story is about lives on the line, and a public health promise that’s beginning to suffocate.
When 70-year-old Sanjay, a retired school teacher, collected his asthma inhaler from a Jan Aushadhi Kendra, he was relieved by the low price. The generic version of his usual branded medicine cost barely a fifth of the latter product. But within days, he was gasping for air.
“I used it again and again, but nothing happened. It felt like I was suffocating,” he recalled. His son, concerned, rushed to a private pharmacy and bought the branded version.. “Just one dose and I could breathe again.” Sanjay said.
This is not an isolated story. Across India, patients relying on Jan Aushadhi Kendras for essential medications are reporting a disturbing pattern: ineffective medicines, crumbling tablets, and prescriptions that run out. At the heart of these failures lies a deeper systemic rot threatening to undermine one of India’s most ambitious public health schemes.
The Promise vs. The Reality
Launched in 2008 and restructured in 2015 under the Pradhan Mantri Bhartiya Jan Aushadhi Pariyojana (PMBJP), the scheme was designed to make quality generic medicines at accessible prices for all. By 2024, the scheme had scaled to over 10,000 Kendras nationwide.
But repeated lapses in drug quality and enforcement have clouded the scheme’s reputation.
In 2019, The Tribune revealed that regulators flagged 25 medicine batches under the Jan Aushadhi banner as substandard. The batches included antibiotics, anti-diabetics, painkillers, and blood pressure medication vital for daily survival.
A separate investigation revealed that in Karnataka alone, over 100 drug batches failed quality checks between 2017 and 2021. Some even reached consumers before recalls were initiated.
Where the System Breaks
Drug regulation in India is deeply fragmented. Manufacturers often secure state-level approvals, bypassing more rigorous and coordinated multilevel oversight. Experts argue that this lack of oversight creates space for substandard drugs to slip into government supply chains including those serving the Jan Aushadhi program.
A 2023 Down To Earth investigation revealed that several lesser-known pharmaceutical companies, often lacking robust manufacturing practices, continue to supply drugs under the scheme.
In some Jan Aushadhi stores, pharmacists admitted off the record that they sometimes had to push branded alternatives when generic stock was unavailable. In others, medicines arrived near expiry or visibly compromised—broken blister packs, chalky tablets, inconsistent dosages.
These aren’t mere logistical lapses. They reflect a deeper crisis of confidence.
The Growing Trust Deficit
While generic medicines are chemically equivalent to branded ones, their public image is fragile. A few quality failures can undo years of awareness-building. And that is precisely what’s happening. Patients interviewed for this story expressed reluctance to return to Jan Aushadhi Kendras. Some cited ineffectiveness, others feared side effects. As a woman managing hypertension put it, “I’d rather spend more than gamble with my health.”
In a country where out-of-pocket healthcare spending pushes millions into poverty each year, this trust deficit is measured not just in rupees, but in lives.
A Program at the Crossroads
The vision of Jan Aushadhi remains crucial for a country still grappling with healthcare inequality. But vision alone isn’t enough. Independent experts are urging stronger regulatory enforcement, routine batch testing, better supplier vetting, and greater transparency around recalls. To restore faith, the scheme must prove that every medicine on its shelves meets the standard it promises. Encouragingly, some parts of India offer a more hopeful picture.
Southern States Show a Path Forward
South Indian states such as Kerala, Karnataka, and Tamil Nadu have outperformed their northern counterparts in both accessibility and operational efficiency. These states boast a higher density of Kendras, enhanced by state-run initiatives like Kerala’s Karunya/Neethi and Tamil Nadu’s CM Pharmacies, which work alongside the Jan Aushadhi scheme to boost public trust.
Better public awareness, stronger supply chains, and proactive state support have led to fewer stockouts and smoother operations in these regions. Importantly, while drug quality concerns remain a nationwide issue, southern states have generally responded more transparently with faster recalls and clearer public communication. This responsiveness has helped them retain a relatively higher level of trust among patients and healthcare providers.
Sanjay, reflecting on his asthma episode, puts it simply: “I want to believe in it. Everyone wants cheaper medicine. But if it doesn’t work when I need it the most, what choice do I have?”
The Jan Aushadhi scheme was conceived as a bold step toward equitable healthcare. But unless its commitment to affordability is matched by uncompromising standards and trust, its low prices may continue to come at an unacceptably high cost.
