The year showed that the South still delivers better outcomes than much of the country, but is under increasing pressure from diseases and risks that its current systems are not fully equipped to handle.
Published Dec 31, 2025 | 11:00 AM ⚊ Updated Dec 31, 2025 | 11:00 AM
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In 2025, healthcare in south India showed both progress and strain. While the southern States continued to outperform much of the country on maternal and child health, disease reporting and public health coverage, they also saw severe dengue outbreaks, rare and often fatal infections, and growing numbers of people living with diabetes, cancer and heart disease.
Climate-linked disease spread, an ageing population and changing lifestyles placed new demands on health systems that have long been held up as models. At the same time, court rulings, policy shifts and enforcement actions exposed gaps in regulation, patient safety and medical oversight.
The events of the year showed that the South still delivers better outcomes than much of the country, but is under increasing pressure from diseases and risks that its current systems are not fully equipped to handle.
South India emerged as the nation’s dengue epicentre in 2025, accounting for 61.8 percent of India’s reported cases, 30,628 out of 49,573, and 95.2 percent of deaths, 40 out of 42. This marked a dramatic shift from 2021, when the region represented only 15.6 percent of cases. Karnataka, Tamil Nadu and Kerala bore the brunt, with climate change, erratic monsoons and rapid urbanisation fuelling mosquito breeding. Kerala’s high mortality rate contrasted sharply with Karnataka’s more effective case management.
Kerala confirmed a Nipah case in Palakkad district on 4 July, involving a 38-year-old woman with no travel history. Over 100 contacts were placed under observation, and containment zones were established. The source of the infection remained unknown, raising concerns about the recurring presence of this deadly brain infection in the State.
Kerala reported 42 deaths and 170 cases of a rare brain infection caused by Naegleria fowleri, the “brain-eating” amoeba. Experts linked the surge to climate change, poor sanitation and cultural practices that expose people to contaminated freshwater. Despite improved vigilance, treatment options remained severely limited.
India recorded its second human bird flu death when a two-year-old girl from Narasaraopet in Andhra Pradesh succumbed to the H5N1 virus on 16 March. The child had reportedly consumed raw chicken meat before falling ill, though no bird flu outbreak was reported in the district.
Tamil Nadu reported its first Covid-linked death of 2025 on 27 May, a 60-year-old man from Chengalpattu with multiple comorbidities. Health officials confirmed chronic kidney disease as the primary cause, with Covid-19 described as an “accidental finding”. The State had recorded 69 cases by that point.
Kerala led India with 32.2 percent of adolescents showing pre-diabetic conditions, far exceeding the national average of 10.4 percent. The State also recorded high cholesterol levels among children and adolescents. Andhra Pradesh showed pre-diabetes rates of four percent, highlighting significant regional disparities.
Nearly one in three middle-aged and older adults in south India had diabetes, with Kerala and Puducherry worst affected at a prevalence of 36 percent. Tamil Nadu and Karnataka followed closely. Urban prevalence reached 30 percent, double the rural rate of 15 percent. The study revealed that 40 percent of cases went undiagnosed, and only one State met any of the WHO’s 2030 diabetes targets.
Hyderabad recorded the second-highest female cancer incidence among major Indian metros, with nearly one in 807 women diagnosed annually. The city reported the country’s highest breast cancer rate at 54 per 100,000 women. Women in Hyderabad faced a 16.7 percent lifetime cancer risk before the age of 75.
Reports of rising heart attacks in Hassan district of Karnataka prompted a State investigation. Of 24 sudden deaths between May and June, 20 were cardiac-related, with 14 victims under the age of 45. More than 75 percent had cardiac risk factors. Minister Dr Sharanprakash Patil clarified that no link existed between Covid-19 vaccines and the deaths, attributing the cases to existing health conditions.
Kerala recorded an infant mortality rate of just five deaths per 1,000 live births in 2023, lower than the United States rate of 5.6. This achievement placed Kerala among the world’s best performers. All southern States significantly outperformed the national average of 25, demonstrating the region’s healthcare strengths.
India recorded 6.5 stillbirths per 1,000 deliveries in 2020, with southern States showing significantly lower rates. Andhra Pradesh recorded 1.183, Tamil Nadu 6.371, Karnataka 3.555, Kerala 4.018 and Telangana 4.637, all substantially below northern States. The study linked these differences to literacy levels, access to caesarean sections and the quality of maternal care.
Kerala reported a sharp rise in congenital disorders among newborns, with Thiruvananthapuram recording the highest numbers. Of the 93,804 samples tested, 193 infants were diagnosed with genetic or metabolic disorders. A legislative committee flagged serious data gaps and urged scientific investigations and stronger screening protocols.
Andhra Pradesh’s C-section rate rose to 56.12 percent in 2024–25, up from 42.4 percent in 2019–21, nearly four times the WHO’s recommended 15 percent. Private hospitals conducted 67.71 percent of deliveries surgically, compared to 41.40 percent in government facilities, a 26-point gap that raised concerns over unnecessary interventions. The government launched midwife training programmes in response.
All public health centres in Kerala began holding weekly wellness clinics for women from 16 September. The clinics provide free check-ups and screenings for anaemia, diabetes, hypertension and various cancers every Tuesday. Health Minister Veena George urged women to use the services for early detection.
Kerala launched a queer-friendly clinic providing safe and affordable access to gender-affirming treatments. The government initiative offered financial assistance alongside medical services, though community members stressed the need for more safe spaces, better treatment options and dignity in their healthcare journey.
On 23 October, the Telangana Cabinet approved the removal of the two-child norm from the Panchayat Raj Act, ending a policy that had been in place since 1994. The State had witnessed the country’s sharpest decline in births over five years, prompting the policy reversal for both rural and urban local body elections.
New SRS 2021 data revealed that fertility rates in south India fell more sharply than earlier estimates, with all five States recording 1.5 to 1.6 children per woman, well below the replacement level of 2.1. Tamil Nadu saw a 21 percent decline in births, Kerala 18 percent, while India overall recorded a 13.1 percent increase between 2013 and 2022.
Telangana projected a 25 percent decline in newborns and an 82 percent increase in the population aged 80 and above by 2036. The five to nine age group is expected to decline by 33 percent, while the over-80 population is projected to surge by 302 percent, signalling significant labour shortages and increased healthcare demands.
Andhra Pradesh witnessed a 291 percent rise in registered infant deaths between 2013 and 2022, from 2,130 to 8,346, even as infant mortality rates declined significantly. The paradox highlighted improved death registration rather than worsening health outcomes, contrasting with Karnataka’s 45 percent decline.
DNA tests revealed a decade-long fertility fraud at Hyderabad’s Universal Srushti Fertility Centre. Dr Pachipalli Namratha’s scheme involved baby trafficking, exploiting desperate couples and vulnerable women. Enforcement Directorate raids across nine locations uncovered forged documents and a multi-State network, leading to 25 arrests. Losses running into millions were documented.
Rachakonda police in Hyderabad arrested an ASHA worker from Malakpet, identified as the kingpin of an interstate child trafficking racket. A total of 27 individuals were arrested, and 10 infants were rescued. The network sold babies for ₹3 to ₹6 lakh, with prices varying by gender. At least 11 infants remained missing.
A 31-year-old woman lost nine fingers following a botched liposuction procedure at a cosmetic hospital in Thiruvananthapuram on 22 February. The family alleged gross negligence and attempts at intimidation when concerns were raised. Police sought a medical board review, with further action pending its findings.
A 49-year-old man from Ernakulam contracted a life-threatening bacterial infection after undergoing a hair transplant at Insight Derma Clinic in Kochi. The procedure, carried out in February, led to multiple surgeries and severe emotional and financial distress. Allegations of gross medical negligence were raised regarding the clinic’s protocols.
Twenty-one patients developed neuro melioidosis, a rare and often fatal brain infection, traced to contaminated saline at a dental clinic in Vaniyambadi. A Lancet study identified a half-used saline bottle as the source. Most patients had undergone procedures at the same clinic between July 2022 and April 2023.
The Andhra Pradesh government approved 58 surgical procedures in general surgery, ENT and ophthalmology for qualified Ayurveda practitioners. The Indian Medical Association strongly opposed the decision, warning that it could compromise patient safety and blur the lines between traditional and modern medicine.
The Karnataka Assembly passed the Drugs and Cosmetics (Karnataka Amendment) Bill, 2025, tightening penalties, shifting legal responsibility and empowering enforcement agencies to act against spurious drugs and cosmetics. Public health experts noted that implementation would determine the real impact.
Karnataka’s Health and Family Welfare Department sought to restrict or ban pigeon feeding in public places, citing lung disease risks from prolonged exposure to droppings and feathers. Using existing laws, violations would attract fines and prosecution.
Rules notified on 31 December 2024, and effective from 16 January 2025, mandated Medical Certification of Cause of Death, providing more reliable data for health policy formulation. The move addressed previously lax certification practices.
The Kerala High Court barred physiotherapists and occupational therapists from using the “Dr” prefix without recognised medical qualifications on 4 November. Citing conflicts with the Indian Medical Degrees Act, 1916, the court directed that they function under qualified doctors.
The Telangana Medical Council declared that multiple private aesthetic certifications from institutions such as COCTRASI, ILAMED and AIAD had “absolutely no recognition whatsoever”, calling them “a colossal waste”. The notice targeted training programmes often used by dentists practising cosmetology.
Following Kerala and Telangana, Tamil Nadu banned the manufacture, sale and distribution of raw egg-based mayonnaise for one year from 8 April, citing public health risks and the potential for foodborne illnesses.
Karnataka planned to launch third-party drug quality testing under the Quality Council of India following representations from pharmacists. The move came amid scrutiny of India’s drug regulatory system after repeated reports of substandard and contaminated medicines.
Multiple batches of Albendazole tablets failed quality checks at the Telangana State Drugs Control Laboratory. Samkem, a Madhya Pradesh-based manufacturer, accounted for nearly 80 percent of the failures. The State postponed National Deworming Day from February to August 2025.
Karnataka ordered the closure of Jan Aushadhi Kendras within public hospital premises on 17 May, citing policy violations. The government stated that hospitals cannot recommend the purchase of medicines from external outlets. Permissions for 207 centres were revoked, impacting the Pradhan Mantri Jan Aushadhi Yojana.
Kerala announced its first skin bank at the Government Medical College Hospital, Thiruvananthapuram, pending approval from K-SOTTO. Plans included a second bank in Kottayam. The initiative followed the 2016 Puttingal tragedy, which exposed gaps in burn care. Standard guidelines for statewide skin banks were being formulated.
Finance Minister Nirmala Sitharaman announced the setting up of 200 cancer daycare centres in government hospitals over three years, mirroring Karnataka’s 2024–25 budget initiative. Karnataka Health Minister Dinesh Gundu Rao described the Union Budget as “disappointing” despite the announcement.
Karnataka included corrective surgeries for scoliosis, kyphosis and lordosis under the Ayushman Bharat Arogya Karnataka Yojana, providing coverage of ₹1.5 lakh. The move made the procedures free in government and empanelled hospitals, benefiting economically weaker families.
Telangana’s 35 government medical colleges, with 4,165 MBBS seats, required at least 417 cadavers for first-year anatomy training under National Medical Commission guidelines, but fewer than 120 were available. Students resorted to notes from previous years, compromising hands-on learning.
Kerala’s urban households paid ₹10,341 annually for hospitalisation, 95 percent above the national urban average of ₹5,290. Rural expenses reached ₹8,655, exceeding the national rural average by 110 percent. Per capita urban costs stood at ₹2,939, 103 percent above the national average.
Andhra Pradesh witnessed political conflict over 10 new medical colleges under the PPP model. Former Chief Minister YS Jagan Mohan Reddy warned that tenders would be scrapped if the YSRCP returned to power. The colleges had originally been sanctioned for public sector implementation by his government.
Jeevanline, launched on 10 September, offered round-the-clock support in Tamil, English and Hindi through the toll-free number 1800 202 8760. The AI-enabled, three-layer platform provided trained psychologists for immediate and confidential counselling. Privacy was protected while logging intervention details.
Tamil Nadu recorded 268 cadaveric organ donations in 2024, the highest nationally and the State’s best performance since 2008. Of these, 146 came from government hospitals and 122 from private facilities. Union Health Minister JP Nadda presented a national award. The donations led to the utilisation of 863 major organs and 637 minor organs.
Kerala became the first Indian State to release a sub-national AMR action plan, the Kerala Antimicrobial Resistance Strategic Action Plan (KARSAP). The One Health approach coordinated action across multiple sectors, addressing WHO-recognised challenges of drug-resistant infections.
Hyderabad-based Biological E partnered with China’s Recbio to manufacture and distribute a 9-valent HPV vaccine. The agreement included technology transfer, clinical development support and future local production. The vaccine, in Phase III trials, targeted HPV-related cancers and genital warts among those aged nine to 45.
A Columbia University study found that 78 percent of groundwater samples in eastern Karnataka exceeded safe uranium limits, with some samples measuring up to 75 times higher than US EPA standards. Over 25 million people relied on groundwater for drinking water, with uranium mobility influenced by underground conditions.
South India hosted a disproportionately large share of India’s HIV key populations, with Karnataka leading nationally in female sex workers, men who have sex with men, and hijra and transgender persons. The State recorded 8.34 female sex workers per 1,000 adult women, placing it among the top five States.
