Kerala Health Minister K. Muraleedharan on Friday, 23 October launched a sharp counter-offensive against his three immediate predecessors in the Communist Party of India (Marxist) [CPI-M], questioning their records in office and ruling out any possibility of resignation amid a deepening political dispute over the state's healthcare management.

The SMA Medicine Controversy

The primary flashpoint in this confrontation is the distribution of medicines for children suffering from Spinal Muscular Atrophy (SMA). Former Health Ministers P.K. Sreemathy, K.K. Shailaja, and Veena George — all CPI-M leaders — jointly attacked the United Democratic Front (UDF) government's handling of the health sector a day earlier, raising concerns over medicines reportedly labelled 'Clinical Trial Only' and whether adequate safety protocols had been observed.

Sreemathy alleged that patients were struggling to obtain life-saving medicines due to what she called the government's 'irresponsible approach.' She maintained that the Left Democratic Front (LDF) government had supplied medicines free of cost throughout its decade in power and that procurement shortages were not a concern during that period. She further alleged that established procurement procedures through the Kerala Medical Services Corporation had been bypassed, resulting in corruption and distribution lapses.

Muraleedharan's Counter-Attack

Muraleedharan dismissed the criticism forcefully. He remarked that 'the days when surgical scissors were allegedly left inside patients during operations were over' — a pointed reference to incidents he attributed to the tenure of the previous LDF government.

'The Congress party made me a minister,' he said, signalling he would not yield to pressure to step down.

He also levelled specific allegations against each of his predecessors: that children had died following infections under one former minister's watch, that deaths had occurred during the Nipah outbreak when another held the portfolio, and that the third had allegedly made a false claim about having been assaulted. The minister further suggested that some television coverage had fuelled the controversy and hinted that foreign pharmaceutical companies could have an interest in shaping such narratives.

On the medicine procurement question, Muraleedharan announced that the government would proceed with an Indian-manufactured drug for SMA patients rather than purchasing a more expensive imported alternative.

Expert Backing for Generic Drug

Prominent neurosurgeon and former Kerala University Vice-Chancellor B. Iqbal has backed the Health Department's decision to use Natco's lower-cost generic Risdiplam, describing it as a step towards making SMA treatment more affordable and accessible to patients across the state.

Political Context and Background

This is not merely a health policy dispute — it is a proxy battle over governance credibility between the ruling UDF and the opposition LDF. Muraleedharan, the son of former Kerala Chief Minister K. Karunakaran, took an unusually personal tone, describing the three former ministers as 'women unwanted by their own party' who had come together to target him. The remark drew immediate attention for its combative register.

This confrontation comes amid broader scrutiny of healthcare delivery in Kerala, a state that has historically prided itself on its public health infrastructure. The dispute has now widened into a full-spectrum political battle over medicine procurement, patient safety, and the comparative record of successive state governments.

With both sides digging in, the row is likely to intensify in the coming days as the state legislature session approaches.