Transformation of Bihar’s health systems through cancer care, medical education, and procurement reform

• Apr 1, 2026
• 2 min

In Bihar, India’s third-most populous state, the public health system struggles with persistent gaps in infrastructure, workforce availability, and diagnostic capacity. Public health facilities operate below required standards due to chronic shortages of health workers, which constrain service delivery. Cancer care is particularly limited, with only eight comprehensive cancer centers for an estimated 109,000 new cases annually and screening rates below 1%. This restricts access to timely, high-quality care for rural and underserved populations. 

The Government of Bihar sought to accelerate progress toward critical health sector development goals across cancer care, medical education, and public procurement to address these challenges.  

MSC supported the Government of Bihar through the establishment of a multi-sector program management unit and the design of targeted interventions across three priority areas: Cancer care, medical education, and public procurement. 

For cancer care, MSC helped establish the Bihar Cancer Care and Research Society. We designed the institutional architecture, supported multi-departmental approvals, and enabled leadership recruitment. This laid the foundation for a state-wide, three-tier cancer care system that spans prevention, treatment, and rehabilitation. 

For medical education, we designed a context-specific public–private partnership (PPP) model for medical colleges to define bidding criteria and eligibility norms. We provided transaction advisory support for the establishment of medical college hospitals under the PPP mode through tailored models for greenfield and brownfield projects. 

For public procurement, we are supporting reforms to streamline procurement governance, enhance transparency, and institutionalize accountability across departments. 

The Bihar Cancer Care and Research Society is now operational, with leadership in place. The three-tier cancer care ecosystem is expected to benefit more than 140,000 new cancer cases diagnosed annually in Bihar and enable population-wide screening for the state’s 131 million residents. 

Medical college hospitals approved under the PPP mode will add nearly 2,300 Bachelor of Medicine, Bachelor of Surgery (MBBS) seats to the existing 1,645 seats in government medical colleges. The establishment of medical colleges and hospitals across greenfield and brownfield sites is expected to mobilize approximately USD 430 million in private investment and USD 95 million in government investment. 

The Gates Foundation commissioned the project.