Shri Narendra Modi,
Prime Minister of India,

South Block,

Raisina Hill

New Delhi 110 011

Subject: ​Letter opposing the Indian Medical Association’s (IMA) demand to rewrite / delete the Chapter 2 Social Science textbook on Social and Political Life (SPL) for Grade 7

Dear Hon. Prime Minister,


We, the undersigned, medical professionals, educationist, academics, teachers, civil society organisations ​and other concerned individuals are writing to express our deep concern vis-a-vis the recent demand by the Indian Medical Association (IMA) for “immediate remedial action” on content included in the National Council of Educational Research and Training (NCERT)’s Social Science textbook on Social and Political Life (SPL) for Grade 7. The IMA’s demand to rewrite or delete the chapter is clearly unreasonable and unacceptable, as are the threats that the IMA has issued against the NCERT and the authors.


Chapter Two on “Role of the Government in Health” in the above-mentioned textbook, sections of which the IMA is raising objections to, is part of a series of textbooks that were developed through a consultative process initiated by the NCERT, involving academics, teachers, researchers, government school teachers and civil society organizations with substantive experience and expertise in the thematic areas covered in the textbooks​ ​during 2005-08.  These textbooks also underwent an independent process of systematic review prior to publication.


The SPL textbooks, as the name suggests, focus on themes related to social, economic and political life in contemporary India building on the well-recognized pedagogic principle that children learn best through concrete examples.  The SPL textbooks aim to develop the abilities of children to critically engage and analyze these realities in keeping with the tenets of the Constitution of India.  The chapter that is under contention, focuses​ on the critical role that equality exercises in Indian democracy and each of the five units of the book highlight a particular issue related to elucidating this theme. Health is one of the issues discussed and is included in Unit 2 on ‘State Government’, which contains two chapters on the “Role of the Government in Health” and “How the State Government Works”.

​ ​

As the titles make clear, these chapters aim to present and discuss the government’s role and responsibilities around providing quality health care for all in a democracy.

Specifically, the chapters attempt to get students to begin thinking critically about inequities in health care, including concerns of availability, accessibility and quality. In presenting these concerns, the chapter includes a discussion of the private and public facilities, which comprise the health sector in India.  The objective of the chapter is not a comparison of the public and private health care sectors, rather the chapter seeks to reiterate the state’s responsibility in a democracy and emphasize the implications of the withdrawal / insufficient provisioning by the government for public goods, namely health care. Reference to this central idea can be found in the “The Story of Hakim Sheikh”, where many government hospitals refused to admit him for treatment. This real case study is used as a running thread through the chapter and illustrates that denial of health care violates the constitutional provision for the right to life. This landmark judgment by the Court would encourage the student to think of the wider public interest and not accept the implications of these situations as natural.


The IMA’s allegations and demands are unfortunate and based on a selective reading of the chapter. The IMA has raised objections to a couple of lines regarding the costs of treatment in the story board – however, following the story board are questions that invite students to look at it in an open ended manner, relate to the social context and bring their own experience in an illness to the classroom. The storyboard is an important educational tool that facilitates students’ understanding of the diversity and inequalities evident in access to health care (not a simple public versus private distinction as has been understood by IMA); and the government’s role in health care provisioning, governance and accountability.


Further, abundant evidence exists that indicates the severe costs of health care in the private health care sector. It is a known fact that private health care is largely unaffordable for the vast majority of Indians. Indeed, out of pocket expenditure on health in India is one of the highest in the world, and health care costs contribute to indebtedness for a significant portion of our population.  According to the World Health Organization (WHO) India National Health Accounts (NHA) data for 2013, out of pocket (OOP) expenditure as percentage of Private Health Expenditure in India, was 86 percent. On average, a much higher amount (four times) is spent for treatment per hospitalized case by people in the private (INR 25850) than in the public (INR 6120). The average cost of hospitalization for childbirth in rural areas is Rs. 1587 and Rs. 14778 and in the urban areas Rs. 2117 and Rs. 20328 in public and private hospitals respectively (NSSO). Health Surveys have also pointed to, for example, that the number of caesarean deliveries in private hospitals was almost three to 10 times more as compared to government hospitals (AHS2012-13). A World Health Organization study, which reviewed 1,10,000 births from nine countries in Asia including India in 2010, revealed more than 60 per cent of the hospitals studied, where these C-sections took place, did it for financial gains and not because it was required. (


The IMA’s objections to sentences, which discuss the private sector and state, “In order to earn more money, these private services encourage practices that are incorrect. At times, cheaper methods, though available, are not used. For example, it is common to find doctors prescribing unnecessary medicines, injections or saline bottles when tablets or simple medicines can suffice.” Evidence of such practices is widely available including in a recently released book based on interviews with 78 doctors across India also includes narratives of “widespread irrational drug prescribing, kickbacks for referrals, and unnecessary investigations and surgical procedures”. (Voices of Conscience from the Medical Profession (SAATHI);,


Further, IMA’s allegation that students will be “brainwashed” against the private health sector, is unfortunate and unfounded.  It has been long established that students, however young, bring to the classroom knowledge and experience that the classroom process needs to facilitate as part of the process of learning. The IMA’s objection to one frame from a storyboard is not only disingenuous but completely misunderstands and disregards the educational requirements of textbooks.


Undoubtedly, there are doctors who conduct ethical private practice, as there are government hospitals that are run effectively. The chapter as currently written provides enough questions in the text to enable students to engage in a discussion based on their health care experiences thereby allowing them to agree or contend with the information that the chapter makes available and to understand that there are implications for society that faces such inequality in access including costs for a basic need, especially given the current environment that is encouraging of privatization- indeed corporatization of health.


As the above data show, a large section of society in our country is denied basic health care. The demand by IMA will result in students receiving a distorted and incorrect representation of issues that the Indian health care sector continues to grapple with.  It would also work to stymie the development of critical thinking skills in students through engaging difficult concepts like ‘equality’ and ‘democracy’ through their own experiences. Sound and proven educational principles should not be allowed to be jettisoned by particular interest groups, irrespective of their political and ideological position.


We, therefore, reiterate the unacceptability of the demands by IMA and oppose any attempts to undermine the intent of these textbooks.  We urge you to reject the demand by IMA to rewrite or delete Chapter 2 on ‘Role of the Government in Health’ in the Social and Political Life Class 7 textbook.




Signed by the Textbook writing team for the SPL textbook for Grade 7:


Dr.Sarada Balagopalan (Chief Advisor), Arvind Sardana (Advisor) Dipta Bhog,

N Sarojini, Malini Ghose, Prof Krishna Menon, Prof Mary John, Prof Anjali Monteiro and Sukanya Bose (Members)




Endorsed by:


  1. Medico Friend Circle (MFC)
  2. Jan Swasthya Abhiyan (JSA)
  3. Forum for Medical Ethics Society (FMES)
  4. Prof. Imrana Qadeer
  5. Prof Anita Rampal, New Delhi
  6. Prof. Uma Chakravarti, New Delhi
  7. Dr. Mira Shiva, Initiative for Health and Equity in Society, Diverse Women for Diversity, New Delhi
  8. Prof Jayati Ghosh
  9. Prof. Krishna Kumar, New Delhi
  10. Dr. Amar Jesani, Editor, Indian Journal of Medical Ethics
  11. Dr. Abhay Shukla, Pune
  12. Dr. Amit Sen Gupta, New Delhi
  13. Dr. Devaki Jain
  14. Prof. Nandini Sundar, New Delhi
  15. Prof. Vijaya Mulay, New Delhi
  16. Dr Syeda Hameed, New Delhi
  17. Adv. Veena Johari, Mumbai
  18. Prof. Ghanshyam Shah
  19. Dilip Simeon, New Delhi
  20. Prof. Zoya Hasan, New Delhi
  21. Dr. Dhruv Mankad
  22. Dr. Vandana Prasad, New Delhi
  23. Dr. Anant Phadke, Pune
  24. Prof Nivedita Menon, Jawaharlal Nehru University, New Delhi
  25. Prof. Nandini Manjrekar, Tata Institute of Social Sciences, Mumbai
  26. Dr Poonam Batra, Central Institute of Education, Delhi University
  27. Admiral L Ramdas, Alibagh
  28. Dr. C. Sathyamala
  29. Dr Aditya Nigam, The Centre for the Study of Developing Societies (CSDS), New Delhi
  30. Harsh Mander, New Delhi
  31. Himanshu Srivastava, Homi Bhabha Centre for Science Education
  32. Uma Sudhir, Eklavya
  33. Prof. Kamal Mitra Chenoy, New Delhi
  34. Dr Sadhna Saxena, CIE, Delhi University, New Delhi
  35. Gagan Sethi, Janvikas, Ahmedabad
  36. Prof. Rajni Pailriwala
  37. Dr. Rakhal Gaitonde, Parent of Class 7 student, Chennai
  38. Kavita Srivastava, Jaipur
  39. Suhasini Mulay, New Delhi
  40. Ravi Duggal, Mumbai
  41. Dr Sanjeevani Kulkarni, Prayas Health Group, Pune
  42. Dr. S.V. Nadkarni, Ex Dean L.T.M. Medical College, Mumbai
  43. Dr. Shree Mulay, Canada
  44. Prof. Susie Tharu, Co-editor Towards a Critical Medical Practice
  45. Dr. Veena Shatrugna, Former Deputy Director NIN, Hyderabad
  46. Prof. Mohan Rao, New Delhi
  47. Prof. Sujata Patel, University of Hyderabad, Hyderabad
  48. Prof. Janaki Nair, New Delhi
  49. Pamela Philipose, New Delhi
  50. Prof. Padmini Swaminathan, TISS, Hyderabad
  51. Prof. Rama Baru, New Delhi
  52. Vimala Ramachandran
  53. Farah Naqvi, Writer and Activist, New Delhi
  54. Kalpana Mehta, Manasi Swasthya Sansthan, Indore
  55. Deepa V., Sama Resource Group for Women and Health, New Delhi
  56. Dr Monisha Behal, North East Network
  57. Sheba George, SAHR WARU, Ahmedabad
  58. Nirantar Resource Centre, New Delhi
  59. Shabnam Hashmi, ANHAD, Delhi
  60. Prof. Gita Sen, Bengaluru
  61. Vani and Ashima, Saheli Women’s Resource Centre, New Delhi
  62. Mujahid Nafees, Education Activist, Gujarat Right to Education Forum
  63. Asha Mishra, Bharat Gyan Vikas Samiti
  64. Disha Nawani, Tata Institute of Social Sciences, Mumbai
  65. Amman Madan, Azim Premji University
  66. Meena Saraswathi Seshu, SANGRAM, Sangli
  67. Dr R Srivatsan, Hyderabad
  68. R Nagaraj, Indira Gandhi Institute for Development Research
  69. Bhupendra Yadav, Azim Premji University
  70. Manisha Gupte, Pune
  71. Simantini Dhuru, Avehi Abacus
  72. S. Srinivasan, Vadodara
  73. Dr Anita Dighe
  74. Arundhati Dhuru, Lucknow
  75. Dr. Narendra Gupta, Prayas, Rajasthan
  76. Prof. Purendra Prasad, University of Hyderabad
  77. Kiran Shaheen, Writer and Anti Poverty activist
  78. Dr. Sagari Ramdas, Sovereignty Alliance
  79. Prof. Sheela Prasad
  80. Gargee Guha, Swayam, Kolkata
  81. Renuka Mishra, New Delhi
  82. Dr. N Raghuram, GGS Indraprastha University, New Delhi
  83. Lalitha Ramdas
  84. Dr. Dinesh Agarwal, New Delhi
  85. Dr. Gopal Dabade, Drug Action Forum- Karnataka
  86. Prof. Rachana Johri, Delhi
  87. Biraj Patnaik, New Delhi
  88. Prof. Atul Sood, New Delhi
  89. Bittu K, University of Hyderabad
  90. Prabha Nagaraja, TARSHI, New Delhi
  91. Aatreyee Sen, Forum for Human Rights and Justice
  92. Dr. Joe Verghese, New Delhi
  93. Dr. Abhijit Das, New Delhi
  94. Dr. Prabir Chatterjee
  95. Virginia Saldanha, Secretary, Indian Christian Women’s Movement
  96. Dr. Amrita Chhachhi
  97. Satinath Sarangi, Sambhavna Trust, Bhopal
  98. Prof Veena Poonacha
  99. Sumi Krishna
  100. Bijoya Roy, New Delhi
  101. Ranjan De, Delhi
  102. Rupsa Malik, CREA, Delhi
  103. Esha, Health Watch Forum, Uttar Pradesh
  104. Kalyani Menon Sen, New Delhi
  105. Dr. V Suresh, Jan Swasthya Abhiyan, Andhra Pradesh
  106. Sulakshana Nandi, Chhattisgarh
  107. Dr. Navsharan Singh, New Delhi
  108. Kumkum Roy, Jawaharlal Nehru University (JNU), New Delhi
  109. Manish Jain, Ambedkar University, Delhi
  110. Dr. Ramani Atkuri, Bhopal
  111. Dr. Varsha
  112. Dr. Ramila Bisht, New Delhi
  113. Suhas Kolhekar, Jan Swasthya Abhiyan and National Alliance for People’s Movements (NAPM)
  114. Vrinda Marwah, New Delhi
  115. Chayanika Shah, Teacher, Activist, Researcher, Mumbai
  116. Simran Sawhney, New Delhi
  117. Kamal Mahendroo, Vidya Bhawan
  118. Arunan M C, Homi Bhabha Centre for Science Education (HBCSE)
  119. Sanjai Sharma, Human Rights Law Network (HRLN), New Delhi
  120. Priya Ranjan, New Delhi
  121. Amulya Nidhi, Indore
  122. Nazia Hassan, New Delhi
  123. Neeraj Malik
  124. Nimisha, Olakh, Vadodara
  125. Koninika, National Federation for Indian Women (NFIW)
  126. Sunita Bandewar, Pune
  127. Rashida Bee, Bhopal Gas Peedit Mahila Stationary Karmchari Sangh, Bhopal
  128. Gurumurthy Kasinathan, IT for Change
  129. Mina Swaminathan
  130. Shikha Sen, Documentary Editor, New Delhi
  131. Rachna Dhingra, Bhopal Group for Information and Action
  132. Trupti Shah, Sahiyar, Vadodara
  133. D. W. Karuna, Historian, Chennai
  134. Pramada Menon, New Delhi
  135. Abha Bhaiya, Himachal Pradesh
  136. Sonia Jabbar, New Delhi
  137. Neha Madhiwala, Mumbai
  138. Sana Contractor, New Delhi
  139. Aswathy Raveendran, PhD Student, Homi Bhabha Centre for Science Education (HBCSE)
  140. Dr. Vinay Kulkarni, Prayas Health Group, Pune
  141. Helen Saldanha
  142. Sheba Chhachhi, New Delhi
  143. Kamayani Bali Mahabal, Feminist and Human Rights Activist, Mumbai
  144. Almas Shamim
  145. Balkrishna Namdeo, Bhopal Gas Peedit Nirashrit Pension Bhogee Sangarsh Morcha
  146. Nawab Khan, Bhopal Gas Peedit Mahila Purush Sangarsh Morcha
  147. Dr. Sunita Reddy, New Delhi
  148. Dr. Abhijit More, Pune
  149. Ameer Khan, Chennai
  150. Adsa Fatima, New Delhi
  151. Gouranga Mohapatra, Bhubaneshwar
  152. Malini Aisola, New Delhi
  153. Sunita Chowdhury, New Delhi
  154. Nandita Bhatla, Delhi
  155. Anjali Shenoi, Pune
  156. Askari Naqvi, Lucknow
  157. Gracy Andrew
  158. Preeti Nayak, Bhubaneshwar
  159. Purwa Bharadwaj, New Delhi
  160. Prof. Bal Chander, Himachal Pradesh
  161. Meera Samson
  162. Padma Deosthali, Mumbai
  163. Disha Mallick, Delhi
  164. Satnam Singh, Rohtak
  165. Rohini Hensman, Writer and Researcher
  166. Runu Chakraborty, Delhi
  167. Mary Scaria
  168. Nandini Rao, Activist, New Delhi
  169. Vaibhao Ambhore, New Delhi
  170. Soma K P, Researcher and Advisor, New Delhi
  171. Rohini Kandhari, New Delhi
  172. Uma V Chandu
  173. Mahesh Daga, New Delhi
  174. Sabala, Mumbai
  175. Kranti, Mumbai
  176. Uma Maheshwari Bhurugubanda
  177. Shalini Joshi, New Delhi
  178. Juhi Jain, New Delhi
  179. Bindhulakshmi Pattadath, TISS, Mumbai
  180. Dr Roshmi Goswami
  181. Purnima Gupta, New Delhi
  182. Pallavi Gupta, New Delhi
  183. Mehzabeen Hussain, New Delhi
  184. Kalyani Badola, New Delhi
  185. Maimoona Molla, Delhi
  186. Jagdish Patel, Vadodara, Gujarat
  187. Prof. K.S. Jacob, Christian Medical College, Vellore
  188. Sudha Nagaravarapu
  189. Kashi Nath Chatterjee, BGVS
  190. Anuradha, Freelance Development Professional
  191. Ritwik De, New Delhi
  192. Tarang Mahajan, New Delhi
  193. Satish Singh, New Delhi
  194. Devaki Nambiar, Delhi
  195. Jaya Sharma, New Delhi
  196. Sangeeta Dasgupta
  197. Anuradha De, New Delhi
  198. Poonam Arora, New Delhi
  199. Sudeshna Sengupta, Alliance for Right to Early Childhood Development
  200. Rupamanjari Hegde, Delhi
  201. Bishakha Datta, Mumbai
  202. Deepika Singh, Ahmedabad
  203. Sharad Behar, Bhopal
  204. Dr Varsha Deshmukh, Detroit
  205. Shailla Baidya, Dubai, School teacher
  206. Khursheed Mehta, Mumbai
  207. Gopika Chowfla, Graphic Designer, New Delhi
  208. Anu Gupta, Dewas
  209. Dr Thelma Narayan, Bengaluru
  210. Madhavi Kuckreja, Lucknow
  211. Susheela Singh, New Delhi
  212. Malini Subramaniam
  213. Shaila Mallik





Arvind Sardana 09425605395

Malini Ghose: 09899019421

Dipta Bhog: 09891400302

Sarojini N: 0918664634

Sarada Balagopalan: 033-24664733