Council on Energy, Environment and Water Integrated | International | Independent

Open Letter to the Government of India and Global Development Community: A Sustainable Energy Path to Universal Healthcare in Rural India

The Government of India (GoI) has taken swift action to stem the impact of COVID-19, saving many lives despite the heavy socio-economic impact on the nation. It will take more time to understand the full repercussions of COVID-19 on India, but it is already clear that the toll on rural areas has been heavy: decreased demand for agricultural goods and supply chain disruptions; millions of migrant workers returning to their home villages; and strain on an already under-resourced healthcare system.

Compounding that stress is the ongoing reality that roughly 39,000 sub-centres (the first contact point between the primary health care system and the community) across rural India serving over 200 million people, or 15% of the country’s total population, are still unelectrified1. Recent experience from solarizing sub-centres in Chhattisgarh state2 has shown that service improved significantly with the addition of rooftop PV and batteries, resulting in better healthcare outcomes (especially for maternal and neonatal), protecting sensitive medical equipment and saving money. In fact, analysis shows that India needs to spend as little as USD $0.37 per person3 to rapidly install reliable, clean energy solutions to end energy poverty for rural clinics.

With the COVID-19 crisis easing and the Phase III Off-Grid and Decentralised Solar PV Applications Programme of the Ministry of New and Renewable Energy (MNRE) ending in 2020, now is the time to seize the moment to ensure that the nation once and for all ensures universal rural healthcare. COVID-19 will not be the last threat of its kind.

We, the undersigned, represent a broad cross-section of institutions from the healthcare and renewable energy sectors. We urge the central and state governments and the international development community to support the below four-step intervention:

1. Expand clinic solarization: The MNRE Off-Grid and Decentralised Solar PV Applications Programme should take the learnings from Chhattisgarh state and accelerate the deployment of renewable energy to power all unelectrified PHCs and sub-centres at a national scale.

2. Allocate dedicated capital: This initiative should be included in the national budget, which currently includes a combined $12.8 billion for renewable energy and healthcare. Given a per sub-centre benchmark cost of INR 74 per watt for solar PV system4 with 3-hour storage, India can electrify all sub-centres for as little as INR 6 billion (USD $85 million) -- just 0.6% of the 2020-21 energy and healthcare budget.

3. Ensure long-term operations: Working through existing structures, such as the state-level National Health Mission (NHM) and renewable energy agencies, as well as Rogi Kalyan Samiti, budget must also be set aside for ongoing operations and maintenance to ensure sustainability beyond the current 5-year warranty periods.

4. Promote innovation: Most medical equipment available on the market today is highly inefficient in terms of power usage, increasing the financial burden on rural clinics. Manufacturers must be incentivized to develop more efficient, ruggedized appliances suitable for rural healthcare theaters.

We stand ready to support the Government of India and state governments in achieving these objectives.



  1. Rev. Dr. Mathew Abraham, Director General, Catholic Health Association of India
  2. Upendra Bhatt, Co-Founder & Managing Director, cKinetics
  3. Dr. Arunabha Ghosh, Founder & CEO, Council on Energy, Environment and Water (CEEW)
  4. Dr. Sudarshan H, Founder, Karuna Trust
  5. Harish Hande, Founder & Chairman, SELCO Foundation
  6. Sanjeev Jain, Chief Engineer, Chhattisgarh Renewable Energy Development Agency
  7. Adwait Joshi, CEO, CLEAN
  8. Dr. Arvind Kumar, Founder Trustee, Lung Care Foundation
  9. Shweta Narayan, Coordinator, Healthy Energy Initiative (India)
  10. Prof. D. Prabhakaran, Executive Director, Centre for Chronic Disease Control
  11. Dr. Poornima Prabhakaran, Deputy Director, Centre for Environmental Health, PHFI
  12. Dr. BK Rana, CEO, Quality Accreditation Institute
  13. Dr. RD Ravindran, Chairman, Aravind Eye Care System
  14. Dr. Sudha Ramalingam, Director, Research & Innovation, PSG Institute of Medical Sciences & Research
  15. Prof. Srinath Reddy, President, Public Health Foundation of India
  16. Dr. Ravikant Singh, Founder, Doctors For You
  17. Dr. Alex Thomas, President, Association of Healthcare Providers India

1 According to the 2019 Rural Health Statistics, 230 million people are served by unelectrified health centres. While the Saubhagya scheme focused on households and ensured near universal access in a timely manner, the absence of a dedicated scheme for the electrification of health centres meant that several centres continue to be unelectrified.

2 https://www.ceew.in/publications/powering-primary-healthcare-through-solar-india

3 Based on India Public Health Standard required equipment guidelines for PHCs and sub-centres. Supplying 800 unelectrified PHCs, 39,000 unelectrified sub-centres with 5kw and 2kw solar PV, respectively, and 3 hour storage (cost calculated according to MNRE benchmark numbers). PHCs serve 25 villages, sub-centres 4 villages.

4 MNRE benchmark costs for standalone solar systems below 10kW with 3 hour back-up is INR 74/watt in the general category and INR 81/watt in the north-east/hilly states and island UTs. These costs are inclusive of total system costs and its installation, commissioning, transportation, insurance, five-year AMC/CMC, and applicable fees and taxes.