The plan includes the transformation of NCDC by setting up five new regional offices, 20 new metropolitan surveillance units and 27 new state regional centers of India’s top public health institute.
The proposals under the upcoming new iteration of the Pradhan Mantri Ayushman Bharat Health Infrastructure Mission (PM-ABHIM) aim to ensure a decentralized response to disease outbreaks. The plan will see 10 new biosafety level 3 (BSL-3) laboratories set up to enable advanced field-level diagnostics to fight pandemics.
The plan includes the establishment of special units to provide health security in congested cities with a focus on hygiene and overcrowding. It gives NCDC full responsibility for providing frontline services and evidence collection, conducting field surveillance, while the Indian Council of Medical Research (ICMR) would focus on medical research.
BSL-3 laboratories are highly enclosed facilities designed to prevent the escape of airborne pathogens and are an integral part of the national strategy for the detection and surveillance of emerging diseases and viruses. India has 35 BSL-3 laboratories run by NCDC, ICMR, Council of Scientific and Industrial Research (CSIR), Indian Council of Agricultural Research (ICAR) and Department of Biotechnology (DBT) and Anusadhan National Research Foundation (ANRF). India has only one Biosafety Level 4 (BSL-4) laboratory at the National Institute of Virology Pune; the highest level of security operated by ICMR to handle the deadliest pathogens including Ebola, Marburg and Lassa viruses.
The development assumes significance as India faces increasing outbreaks of infectious diseases including zoonotic ones such as Nipah virus, Zika virus, Avian Influenza (H5N1), Crimean Congo Hemorrhagic Fever (CCHF), Kyasanur Forest Disease or Monkey Fever, Leptospirosis, Japanese Encephalitis and Bush Typhus which have caused a large number of fatal cases in the last five years. Chikungunya, influenza A (H3N2), human metapneumovirus (HMPV) and Guillain-Barré syndrome (GBS) are also on the rise.
The ₹64,180 crore-PM-ABHIM scheme will end in the current fiscal year (FY26). Beginning in FY27, the system will have new budget allocations to provide disease surveillance and laboratory maintenance. The Mint could not detect the new budget allocation. The government took the final call for allocations closer to the budget announcement, scheduled for February 1, keeping in mind the fiscal scenario, specific funding needs and macroeconomic outlook.
The New Delhi-based NCDC manages the Indian SARS-CoV-2 Genomics Consortium (INSACOG) for genomic surveillance of covid-19 variants. NCDC currently has eight outstation branches located in Jaipur (Rajasthan), Bengaluru (Karnataka), Kozhikode (Kerala), Chennai (Tamil Nadu), Raipur (Chhattisgarh), Patna (Bihar), Mangalgiri (Andhra Pradesh) and Varanasi (Uttar Pradesh).
“By modernizing these facilities, the government intends to bridge critical gaps in the public health network, allowing for faster identification and containment of infections,” said the second government official cited above. “This strategic move aims to create a pandemic-resilient health care system.”
India had 237 biosafety laboratories as of March 2025 and this number is considered extremely insufficient to cater to the country’s population with increased zoonotic threats that require a much larger network to ensure that samples do not have to travel hundreds of kilometers for high content testing.
The Department of Health Research (DHR) also operates 165 laboratories, including 11 BSL-3 and 154 BSL-2 facilities. While ICMR operates 21 laboratories, including the only BSL-4 facility in the country, 26 laboratories come under DBT, 11 under CSIR and 9 under ICAR. Anusandhan National Research Foundation (ANRF) also operates five dedicated BSL and Animal Biosafety Level (ABSL)-3 laboratories. India also has a network of 165 Virus Research and Diagnostic Laboratories (VRDL) set up by the Department of Health (DHR) and ICMR.
Inquiries emailed to spokespeople for the Departments of Finance and Health and Family Welfare on Jan. 20 remained unanswered as of press time.
Dr. Reflecting on the critical gaps exposed by the recent epidemic, Sujeet Singh, former NCDC director, said, “India should move beyond the quiescent phase” that usually follows a pandemic. Our laboratory detection capacity was quite limited. During the 2018 nipah outbreak, we faced delays in diagnostic tests that contributed to deaths as samples had to travel 600 km and so on. In the covid-19 outbreak, existing laboratories including NCDC and NIV (National Institute of Virology) Pune were overwhelmed with samples during the pandemic To address these vulnerabilities, the country needs a strong network of at least 15 BSL-3 laboratories and a dedicated BSL-4 facility for human samples.
“The establishment of five high-capacity regional centers is needed to decentralize the burden to Delhi, and these must be ‘technical centers’ rather than mere administrative branches,” added Dr. Singh. “Our health problems in the East, West, North and South are different. NCDC should raise its level to BSL-4 like CDC Atlanta… We should become a regional center for the Southeast Asian region.”
Raman Gangakhedkar, a former chief scientist of epidemiology and communicable diseases at the ICMR, said the redesign plan is “crucial for our future survival” — whether it’s detecting new organisms or investigating outbreaks. “While ICMR will remain supportive, its primary mandate is to generate evidence and identify diseases rather than providing services,” he added.
India has overtaken China to become the world’s most populous country in 2023. Its six megacities—Delhi, Mumbai, Kolkata, Bangalore, Chennai and Hyderabad—have over 10 million residents each, and then there are 53 urban centers with over 1 million residents each.
“The need for specialized metropolitan monitoring units is vital to managing urban health security. Our metros have a large population, and if you don’t have a clear metropolitan monitoring unit, you won’t be able to address outbreaks and conduct robust disease surveillance. It needs to have a completely different structure to address urban issues like overcrowding and sanitation,” said Dr. Singh.
