Content
Savings shift reshapes India’s markets
Narco Tests
Why human-rating matters as India prepares for Gaganyaan
DPIIT signals Copyright Act changes to address AI issues
Mexico imposes 50% tariffs on Indian and other Asian imports
2,805 deaths while awaiting organ transplants since 2020
Savings shift reshapes India’s markets
Why is it in news?
NSE Market Pulse (2025) reports a major structural shift: domestic household savings (direct equity, MFs, SIPs) are now replacing Foreign Portfolio Investors (FPIs) as the dominant force in Indian capital markets.
FPI ownership:
16.9% of total equities
24.1% in NIFTY 50
Domestic investors now hold ~19%, the highest in over 20 years.
This shift:
Improves market stability by reducing reliance on volatile global flows.
Brings millions of new retail investors into markets — many without adequate financial literacy.
Raises concerns on inclusive growth, investor protection, inequality, corporate governance, and policy preparedness for Viksit Bharat 2047.
Relevance
GS3 – Economy
Capital market deepening
Household savings behaviour
Financialisation
FPI flows vs domestic flows
IPO markets, valuation discipline
Implications for inclusive growth
GS3 – Financial sector reforms
Passive investing
Investor protection norms
SEBI regulatory design
Corporate governance
What is happening in India’s capital markets?
Declining FPI dominance
Historically, FPIs moved markets; their exits triggered volatility.
Their ownership share has declined sharply, reaching a 15-month low.
Rise of domestic savings
Mutual fund AUM hitting new highs.
SIP inflows at record levels.
Retail investors emerging as the new market anchor.
What enabled this shift?
Digital investment platforms.
Low-ticket SIPs; demat penetration.
Low inflation (CPI: 0.3% YoY in Oct) → higher real returns.
Strong macroeconomic stability.
Policy implications
Lower dependence on foreign inflows →
RBI gets greater flexibility.
Less pressure to defend the rupee.
Can focus on domestic credit expansion and the growth–inflation balance.
But stability depends on broad participation, not a narrow investor base.
The market structure shift: why it matters
Lower volatility
Domestic support acts as a buffer against FPI outflows.
October NIFTY rally was driven primarily by domestic buying.
Boom in primary markets
FY25: 71 IPOs, raising ₹1 lakh crore+.
Investment announcements: ₹32 lakh crore, up 39% YoY.
Private sector share: ~70% of proposed investments.
But valuations are rising faster than fundamentals in some segments.
Emerging risks: unequal participation and limited returns
Unequal access
Higher participation in:
Urban regions
Higher-income households
Areas with formal financial infrastructure
Women, rural citizens, lower-income groups remain marginal.
“Performance problem” in active funds
Most active funds fail to beat the index after adjusting for:
Risk
Fees
New investors unknowingly pay high charges for poor relative performance.
IPO overvaluation
Examples: Lenskart, Mamaearth, Nykaa.
High P/E multiples → risk of losses for retail subscribers.
Decline in household equity wealth
Q4: fall of ₹2.6 lakh crore.
Concentrated losses among vulnerable investors undermine:
Trust
Inclusivity
Consumption demand (due to lower MPC)
The inequality dimension
Who benefits?
Gains accrue mainly to:
Higher-income households
Those with better financial acumen
Urban and already economically secure groups
Wealth concentration reduces demand
High-income households save more and consume less → weakens overall demand.
Inclusive growth at risk
Markets may become stable but unequal without safeguards.
The access asymmetry problem
Today’s system emphasises:
Disclosure over actual protection
Participation over meaningful capacity
Volume over equitable outcomes
Needed shifts
From “more investors” → “safer investors”
From expensive active schemes → low-cost passive/index funds
Current imbalance
Active funds: 9% of market
Passive funds: 1%
This skews outcomes against small investors.
Corporate governance concerns
Promoter holding in NIFTY 50 at a 23-year low (40%).
Must ensure:
Genuine capital raising — not promoter exit-driven dilution
Strong disclosure and transparency norms
Protection of domestic savers’ long-term value
What India must do next — policy directions
Strengthen investor protection
Suitability norms
Anti–mis-selling regulations
Risk-adjusted performance disclosure
Expand passive investment
Reduce expense ratios
Promote index funds through NPS, EPFO, PMJDY-linked products
Deepen financial literacy
Target groups:
Rural households
Women
Youth
First-time investors
Improve corporate governance
Stricter disclosure
Monitor promoter selling
Address IPO pricing excesses
Use data-driven policy
Gender-disaggregated data
Location-specific investment trends
Income-linked participation gaps
F. Maintain market integrity
Monitor bubbles
Regulate overvalued IPOs
Encourage long-term investing culture
Narco Tests
Why is it in news?
The Supreme Court has set aside a Patna High Court order (Amlesh Kumar v. State of Bihar, 2025) that permitted a forced narco test.
The Court reaffirmed that any involuntary narco-analysis test is unconstitutional, violating:
Article 20(3) – protection against self-incrimination
Article 21 – right to life, privacy and autonomy
SC held the High Court order to be contrary to Selvi v. State of Karnataka (2010), the landmark judgment regulating narco, polygraph and brain-mapping tests.
Relevance
GS2 – Constitution & Polity
Article 20(3), Article 21, Right to Privacy
Selvi 2010 guidelines
Limits of police power
Due process and fair procedure
GS3 – Internal Security / Criminal Justice
Investigative tools vs constitutional safeguards
Ethical boundaries in criminal investigations
What is a narco test?
A narco test involves administering barbiturates such as Sodium Pentothal to induce a sedated, trance-like state.
Purpose: to reduce inhibitions, weaken reasoning ability, and encourage disclosure of suppressed or concealed information.
It is part of “scientific investigative techniques”, similar to:
Polygraph (lie detector)
Brain mapping (BEAP test)
Key point: It is a non-invasive but intrusive psychological intervention that manipulates the mental state of an individual.
Why are narco tests constitutionally problematic?
Article 20(3) – Right against self-incrimination
No person accused of an offence shall be compelled to be a witness against himself.
Narco tests can extract involuntary verbal responses, violating mental privacy and autonomy.
SC: Without free, voluntary and informed consent, the test is unconstitutional.
Article 21 – Right to life, personal liberty and privacy
Includes bodily integrity, mental autonomy, and right to privacy (Puttaswamy 2017).
Forcibly altering a person’s mental state is a grave intrusion into liberty and human dignity.
Any state action affecting personal liberty must follow just, fair and reasonable procedure (Maneka Gandhi, 1978).
The “Golden Triangle”: Art 14–19–21
Violation of privacy and consent = violation of life and liberty, which affects equality and freedom as well.
Narco tests without consent fall outside constitutionally permissible limits.
Democratic criminal justice principles
Indian justice system must balance:
Victim’s right to justice
Accused’s right to liberty
Forced narco tests tilt the balance towards coercive state power, undermining due process.
Selvi v. State of Karnataka (2010): The governing framework
Selvi is the controlling precedent; the Court held:
No compulsory administration
Narco-analysis, polygraph, brain-mapping cannot be conducted without informed consent.
Consent must be:
Free, voluntary, informed
Recorded before a judicial magistrate
Accompanied by legal and medical safeguards
Test results are not standalone evidence
They may only give investigative leads.
Any information extracted must be independently corroborated.
Protects mental privacy
“The mind is the ultimate repository of personal freedom.”
The state cannot forcibly access it.
The recent judgment reaffirms that Selvi binds all courts.
Evidentiary value: What have courts held?
Manoj Kumar Saini v. State of MP (2023)
Narco results cannot confirm guilt.
They are at best investigative clues.
Vinobhai v. State of Kerala (2025)
Information from narco must be corroborated by other evidence.
The test does not have probative evidentiary value on its own.
Supreme Court’s position
Test permissible only when voluntarily undertaken.
Cannot substitute proper investigation.
Results cannot be treated as confessions or admissions.
No “indefeasible right” to demand such tests — even voluntary requests fall under judicial scrutiny.
Can an accused volunteer for a narco test?
Yes — but with strict conditions:
Voluntary request allowed only at defence evidence stage, under Section 253 of BNSS.
Magistrate must ensure:
Free and informed consent
Understanding of implications
Medical and legal safeguards
Even voluntary tests do not guarantee admissible evidence unless corroborated.
Ethical foundations: Why consent matters
Autonomy and natural justice
Informed consent flows from individual autonomy — a core moral principle.
Immanuel Kant: an act is ethical only when performed with consent.
Forced narco tests undermine:
Human dignity
Mental freedom
Bodily and psychological integrity
Forced truth extraction violates human rights norms
International legal philosophy rejects coercive interrogation.
UN principles also discourage techniques manipulating consciousness.
Does banning involuntary narco tests weaken investigations?
No. SC emphasises:
Investigative efficiency cannot override constitutional rights.
Narco tests:
Are not reliable
Are prone to suggestion, hallucination, false narratives
Cannot replace evidence-based investigation
The police must rely on:
Forensics
Material evidence
Witness statements
Digital trails
Narco-analysis remains a supplementary, not primary, tool.
Why human-rating matters as India prepares for Gaganyaan
Why is it in news?
As India prepares for its first human spaceflight under Gaganyaan, the process of human-rating the LVM-3 rocket has become central to mission readiness.
ISRO is upgrading LVM-3 to HLVM-3, incorporating redundancy, fault tolerance, crew safety systems, and extensive qualification tests.
The article explains what human-rating means, why it is complex, and how global agencies certify their launch systems.
This marks India’s entry into the league of nations capable of launching humans into space, requiring the highest safety standards.
Relevance
GS3 – Science & Technology
Human spaceflight, launch vehicle engineering
Risk management, redundancy design
Cryogenic propulsion, escape systems
GS3 – Indigenisation & Strategic Tech
Atmanirbhar Bharat in space
Indigenous capability for human spaceflight
Technology sovereignty
What is human-rating?
Human-rating is the engineering, testing, and certification process that ensures a launch vehicle and spacecraft are safe enough to carry humans.
Key features
Establishes an acceptable level of risk.
NASA threshold: 0.2% probability of catastrophic loss of crew during ascent/descent (1 in 500).
Ensures the system can tolerate failures and still protect astronauts.
Core requirements
Redundant systems (triple/quadruple redundant flight computers).
Crew Escape System (CES): must work instantly at any point during ascent.
Fault tolerance: vehicle must survive and recover from single-point failures.
Environmental control and life support system (ECLSS).
Extensive qualification and documentation far beyond that required for cargo rockets.
Human-rating is not just hardware modification; it is a systems-level safety philosophy.
Why is human-rating so challenging?
Extreme launch environment
Rocket must accelerate to 28,000 km/h in 8–10 minutes.
Experiences:
High vibration
Severe acoustic loads
Maximum dynamic pressure (Max-Q)
Rapid staging events
Zero tolerance for failure
Cargo missions can fail without loss of life; human missions cannot.
Airplanes have backup landing options and glide capability; rockets do not.
Reliability standards
Best orbital launch vehicles: 98–99.5% success rate.
Commercial aviation: 1 fatal accident per 10–20 million flights — far safer.
Added mass & complexity
Redundant systems and escape mechanisms:
Increase mass → reduce payload capability
Introduce potential new failure modes
Increase development cost and documentation burden
High cost
Human-rating can multiply overall mission cost by 1.5–3×.
Human-rating therefore demands a shift from “mission success” to “crew survival at all costs.”
Which global launch vehicles are human-rated?
Operational today
Russia’s Soyuz-2
China’s Long March 2F
SpaceX Falcon 9 + Crew Dragon
Near-operational / undergoing certification
ULA Atlas V with Boeing Starliner
Completed crewed test flight (2024), awaits formal certification.
NASA’s Space Launch System (SLS)
Human-rated, flew uncrewed Artemis I; first crewed flight upcoming.
Reliability records
Soyuz: ~150 crewed missions since 1967; two early fatal missions; 100% crew survival since 1971.
Space Shuttle: 135 missions, 133 successes (98.5%); two catastrophic failures.
Crew Dragon (Falcon 9): 20 crewed orbital flights → 100% success.
Why aren’t all launch vehicles human-rated?
High cost of certification
Requires:
Structural strengthening
Redundancies
Software certification
Safety assurance processes
Abort systems
Reduced performance
More mass → lower payload to orbit.
Different mission priorities
Cargo rockets maximise:
Cost-efficiency
Payload capacity
Human-rating would make them uneconomical.
Added complexity
Each additional system is a potential failure point.
Hence, only nations with sustained human spaceflight programmes invest in human-rating.
Human-rating for Gaganyaan: ISRO’s upgrades to LVM-3
LVM-3 → HLVM-3 (Human-rated LVM-3)
Modifications and upgrades
Crew Escape System (CES) for rapid abort during ascent.
Enhanced redundancy in avionics and flight computers.
Strengthened engines: Vikas (liquid), C25 cryogenic stage, S200 solid boosters.
Greater subsystem reliability through qualification tests.
Fault tolerance built into critical components.
Improved quality assurance & documentation, aligned with global standards.
Why LVM-3 was chosen
Track record of seven consecutive successful orbital flights (including Chandrayaan-3).
Fully indigenous propulsion architecture → strategic autonomy under Atmanirbhar Bharat.
Highest payload capability in ISRO’s fleet.
Who certifies human-rating? Global frameworks
NASA
Sets human-rating standards for:
SLS
SpaceX Crew Dragon
Boeing Starliner
FAA licenses launch operations but does not certify crew safety.
China
Certification by China Manned Space Agency (CMSA).
Russia
Roscosmos certifies Soyuz rockets and spacecraft.
India (ISRO)
Human-rating certification conducted internally through:
Human Space Flight Centre (HSFC)
Vikram Sarabhai Space Centre (VSSC)
Committee of national aerospace experts
Final safety approval is issued only after:
Flight tests
Uncrewed demonstrations
Abort test success
How successful are human-rated rockets historically?
Soyuz
~150 crewed missions
Two early fatalities (1967, 1971)
100% crew safety since 1971
Crew escape system saved astronauts in 1975, 1983, 2018
Space Shuttle
133 successes / 135 missions (98.5%)
Two catastrophic losses (1986, 2003)
Falcon 9 + Crew Dragon
20/20 crewed missions successful
Most reliable active human-rated system
Long March 2F + Shenzhou
16 crewed missions; mostly successful
One 2025 incident: Shenzhou-20 damaged by space debris (crew evacuated safely)
DPIIT signals Copyright Act changes to address AI issues
Why is it in news?
The Union Government has indicated that major amendments to the Copyright Act, 1957 will be introduced within three years to address challenges arising from AI training and Generative AI (GenAI).
The Department for Promotion of Industry and Internal Trade (DPIIT) released a working paper proposing:
A blanket licensing framework for AI data scraping.
Creation of a Copyright Royalties Collective for AI Training (CRCAT) to collect and distribute royalties to content owners.
This comes amid global legal disputes between AI firms (OpenAI, Google, Meta) and publishers alleging unauthorized use of copyrighted content for AI model training.
Indian industry body Nasscom dissented, warning that the proposal may impose an unworkable burden of proof on AI developers.
Relevance
GS2 – Governance & Policy
Regulatory challenges of emerging technologies
Balancing innovation with rights protection
Role of state in digital economy governance
GS3 – Economy, Technology & IPR
Copyright law
Digital economy
AI governance
Tech policy reforms
Why Is Copyright Relevant to AI?
How AI training works
Large Language Models (LLMs) like ChatGPT, Gemini, LLaMA etare trained on:
News articles
Books
Websites
Social media
Public datasets
This training copies, stores, and analyses massive amounts of text → raises copyright issues.
The conflict
Publishers claim:
AI companies profit from their content without permission or payment.
AI companies claim:
Training use is “fair use” (in some jurisdictions).
Output is transformative, not reproducing the original text.
This legal ambiguity is what India seeks to resolve.
What DPIIT Proposes ?
Blanket Licensing Framework
AI developers can legally crawl/scrape publicly available content.
But they must pay royalties when the model is commercialised.
Payments made via CRCAT, a central copyright society.
Role of CRCAT
Collect royalties from AI firms.
Distribute them to content owners:
News publishers
Digital platforms
Website owners
Other copyright holders
Opt-out debate
Big Tech firms argue publishers should be able to opt out of AI training.
DPIIT’s blanket licensing is effectively opt-out–resistant.
Future Paper
The next DPIIT working paper will examine:
Whether AI-generated works are copyrightable.
Who should be treated as the author:
AI system?
Human prompting the system?
AI developer?
Why Are Amendments Needed?
Current law does not address AI training
Copyright Act, 1957 predates AI.
Key gaps:
Does training = copying?
Is scraping allowed without permission?
Who owns AI-generated content?
Global litigation pressures
ANI (India), New York Times (U.S.), and others have sued AI firms for unlicensed usage and “regurgitation”.
India wants legal clarity
Protect content creators.
Enable AI innovation.
Create certainty for investors and startups.
Objections from Tech Companies
Big Tech firms and Nasscom raise several concerns:
Burden of proof reversed
Normally:
Content owner must prove infringement.
DPIIT model implies:
AI developer must prove they did not use someone’s content.
For probabilistic models, proving non-use is technically impossible.
Running cost increases
Royalty payments may raise entry barriers for startups.
Blanket licensing may trigger global disputes
Because different jurisdictions treat training data differently.
Unpredictable liabilities
If outputs resemble copyrighted text, developers may face legal exposure.
Legal and Ethical Dimensions
Fair Use vs. Copyright Infringement
India does not have U.S.-style broad “fair use”.
Indian law relies on “fair dealing”, which is narrower.
Transparency & accountability
AI models trained on copyrighted text must disclose:
Whether they used copyrighted material.
Nature of data sources.
Moral rights
Indian copyright protects:
Attribution
Integrity of work
AI-generated transformations may impact these rights.
Creator livelihood protection
Especially for:
News publishers
Photographers
Writers
Digital platforms
Global Context
EU Artificial Intelligence Act
Requires:
Training data disclosure
Copyright-compliant datasets
UK & Japan
More liberal; allow text and data mining.
U.S.
Ongoing lawsuits; no clear legislative framework yet.
India
Seeking middle path:
Enable AI innovation
Protect content owners
Create licensing infrastructure
Key Challenges
Identifying data sources
AI developers often lack logs at granular level.
Valuation of royalties
How to price data contribution?
How to assess relative importance?
Preventing monopolies
Blanket licensing might entrench only big players.
Enforcement
Hard to track whether developers used Indian content.
Grey area: Publicly available vs. Public domain
Availability ≠ copyright-free.
Way Forward
Layered licensing regime
Allow:
Free use for research and academic training
Royalty-based use for commercial LLMs
Clear opt-out mechanisms
Allow publishers to block crawlers.
Mandatory transparency disclosures
Training data sources
Model architecture
Safety evaluations
Royalty calculation standards
Views per article
Weight of content
Model size & commercial use
Strengthen India’s copyright society infrastructure
Efficient distribution
Dispute resolution
Audit mechanisms
F. Protect Indian startups
Tiered royalty slabs
Exemptions for early-stage models
Mexico imposes 50% tariffs on Indian and other Asian imports
Why is it in news?
The Mexican Senate has approved 50% import tariffs on cars and hundreds of items from India, China, and other Asian economies that do not have trade agreements with Mexico.
This follows the U.S. imposing steep tariffs on Chinese and certain Indian goods, which has redirected trade flows toward Mexico — causing concerns in Mexican policy circles.
India’s exports to Mexico—especially vehicles, auto components, machinery, chemicals, and nuclear reactors—face significant disruption.
The tariffs come into force in January 2026, threatening India’s growing auto-export market and complicating its supply chains dependent on North America.
Relevance
GS2 – International Relations
Trade disputes
Diplomacy in economic policy
Impact of U.S.-Mexico-China interactions on India
GS3 – Economy
Export competitiveness
Tariff impact on industries
Protectionism and global trade dynamics
Supply chain relocation
What exactly has Mexico done?
Tariff Decision
Mexico has imposed:
50% tariff on passenger cars
Tariffs on hundreds of other items from countries without trade agreements with Mexico.
Affects India, China, Indonesia, Vietnam, and others.
Why Mexico Can Do This
Mexico’s trade architecture is dominated by:
USMCA (U.S.–Mexico–Canada Agreement)
Few FTAs with Asian nations
Countries without FTAs receive non-preferential MFN tariffs, which Mexico is now sharply increasing.
India’s Export Exposure
Top Indian exports to Mexico (Apr–Sep 2025):
Vehicles & parts – $985.75 million
Electric machinery – $316.06 million
Nuclear reactors & parts – $284.61 million
Organic chemicals – $163.55 million
Total India–Mexico trade is ~$15 bn annually.
Why has Mexico imposed these tariffs?
Protecting Domestic Industry
Mexico seeks to shield:
Local automobile industry
Electronics and machinery producers
Given rising Asian imports, Mexican industry groups lobbied strongly for protection.
Response to Rising Asian Shipments
In 2024–25, exports from India and China surged, partly due to:
Diversion of supply after U.S. tariffs on China/India
Indian automakers scaling shipments (compact cars, parts) via Mexico to the Americas
Revenue Generation
Mexico aims to raise ₹37.6 billion additional revenue over three years through tariffs.
Anti-circumvention of U.S. Tariffs
U.S. fears “tariff-jumping”:
Chinese/Asian goods entering U.S. via Mexico.
Mexico is tightening controls to:
Preserve USMCA
Avoid retaliation from the U.S.
Political & Electoral Pressure
Strong lobbying by:
Mexican auto workers’ unions
Local manufacturers
Populist political constituencies
Economic impact on India
Major Impact on Auto Exports
India exports close to $1 billion worth of small cars and auto components to Mexico annually.
Cars designed for Mexico may now become commercially unviable.
50% tariff sharply reduces price competitiveness.
Potential Loss of Market Share
Indian exporters may lose to:
U.S. manufacturers
European OEMs
Mexico-based assemblers
Korean and Japanese firms with FTAs
Disruption to Supply Chain Linkages
Several Indian component suppliers feed into:
Mexican assembly lines
North American EV ecosystem
Tariffs could disrupt these supply chains.
Industry Reaction
SIAM (Society of Indian Automobile Manufacturers) has flagged:
Threat to India’s competitive position
Need for urgent diplomatic outreach
Possible Decline in 2026 Exports
Projections indicate a 10–15% fall in India’s Mexico-bound auto exports if tariffs remain.
Wider geopolitical context
U.S.–China–India Trade Rivalry
U.S. has imposed tariffs on:
EVs
Batteries
Autos
Steel/aluminium
Asian firms redirecting exports to Mexico are now being blocked.
Mexico’s Alignment with U.S. Interests
To avoid violating USMCA, Mexico must prevent:
Transshipment
Duty evasion
Over-reliance on Asian imports
Latin American Protectionism Rising
Other Latin American countries may consider similar measures.
Implications for India’s policy and industry
Need for Trade Negotiations
India requires:
A bilateral trade dialogue
Market access guarantees
Sector-specific tariff relief
Reorientation Toward Other Markets
Indian automakers may divert supply to:
Southeast Asia
Africa
Middle East
Latin America (non-Mexico)
Opportunities to Localise in Mexico
Indian firms may consider:
Setting up local assembly
Joint ventures
CKD/SKD pathways to bypass tariffs
Strengthening India’s Domestic Competitiveness
Tariffs highlight need for:
Higher R&D spending
EV competitiveness
Stronger supply-chain integration
What happens next?
Monitoring U.S.–Mexico–India Triangle
Further U.S. tariffs could trigger more countries to adopt protectionist measures.
India’s Diplomatic Strategy
Inter-ministerial discussions (MEA, Commerce) underway.
India may seek:
Transitional relief
Carve-outs for EVs or small cars
Lower tariffs on intermediate goods
Industry-level Adjustments
Carmakers may revise:
Product lines
Pricing
Export allocations
2,805 deaths while awaiting organ transplants since 2020
Why is it in News?
The Union Health Ministry informed Parliament (Dec 2025) that 2,805 patients died while waiting for an organ transplant since 2020.
Data provided by NOTTO (National Organ and Tissue Transplant Organisation) highlight severe organ shortages and long waiting periods.
The government has introduced new digital reforms, including:
Removal of mandatory domicile or registration-state restrictions.
A new uniform national criterion for cadaveric organ allocation.
Emphasis on centralised, equitable, need-based distribution.
The figures expose the mismatch between demand and availability, and underline the urgent need to strengthen India’s cadaveric organ donation ecosystem.
Relevance
GS2 – Health & Governance
Public health delivery
Organ donation policy
Ethical governance
Digital systems and national registries
GS3 – Science & Technology
Medical logistics
Transplant technologies
Biomedicine and health infrastructure
What is Organ Transplantation in India?
Types of Donation
Living donor transplants
Kidney, part-liver, bone marrow
Deceased (cadaveric) donor transplants
Heart, lungs, pancreas, full liver, corneas
Governing Framework
Transplantation of Human Organs and Tissues Act (THOTA), 1994
National network:
NOTTO (National level)
ROTTO (Regional)
SOTTO (State)
India’s Organ Gap
Demand far exceeds supply:
Kidney: need ~2 lakh/year; transplants ~25,000
Liver: need ~50,000; transplants ~3,200
Heart: need ~30,000; transplants <250
What the New Parliamentary Data Shows ?
Deaths While Awaiting Transplants (2020–2025)
Total deaths: 2,805
Highest:
Delhi – 1,425
Maharashtra – 297
Tamil Nadu – 233
Patients Currently on Waitlist
82,285 patients awaiting organ transplants (as of Dec 2025).
State-wise waiting load
Maharashtra: 20,553
Gujarat: 18,992
Tamil Nadu: 16,966
Delhi: 8,883
Karnataka: 7,405
These numbers demonstrate high geographic concentration of demand.
Which Organs Are Most in Demand?
Kidney
Largest waiting list: ~65,090 patients nationwide.
Liver
18,724 waiting.
Heart
1,659 waiting.
Lung
Smaller numbers, but mortality is high due to scarcity.
Why Do So Many Patients Die Waiting?
Low cadaveric donation rate
India’s deceased donation rate: <0.7 per million population
Spain: ~46 pmp
U.S.: ~38 pmp
Limited ICU infrastructure
Organ retrieval requires:
Ventilator support
Trained ICU staff
Shortages restrict the pool of potential donors.
Logistical constraints
Organ viability windows:
Heart: 4 hours
Liver: 8–12 hours
Kidney: up to 24 hours
Lack of:
Green corridors
Air ambulance infrastructure
State-level coordination
→ leads to lost organs.
Restrictive allocation rules (earlier)
Hospitals often preferred in-state patients.
Lack of unified national queue led to inequitable access.
Low public awareness
Cultural hesitancy, myths, lack of donor pledges.
F. Cost Barriers
Transplants expensive:
Kidney: ₹5–8 lakh
Liver: ₹20–30 lakh
Low insurance penetration compounds challenges.
Recent Reforms Introduced by NOTTO / Union Govt.
Removal of domicile restrictions
Organs no longer restricted to:
State of registration
State of retrieval
→ Enables national pooling → boosts fairness.
Uniform waiting-list criteria
Priority now based on:
Urgency
Waiting time
Medical compatibility
Severity
National-level digital registry
Single national system covering:
Listing
Allocation
Matching
Transport logistics
Promoting organ retrieval centres
Increasing number of authorised hospitals.
Linking Ayushman Bharat with transplant packages
Reducing out-of-pocket burden for poorer families.
Key Ethical and Policy Considerations
Equity in Access
Need to prevent:
Hospital-level biases
Regional monopolies
“First come–first served” overriding urgency
Transparency
Algorithms for matching must be publicly auditable.
Incentive alignment
Non-monetary incentives for families:
Honouring donors
Fast-track benefits
Ethical prohibition
No room for:
Commercial sale of organs
Coercion
Exploitation of the poor
Strengthen Cadaveric Donation Movement
Spain, U.S. models show success through:
Mandatory referral
Trained transplant coordinators
National awareness drives