Anitha's Country: India's Underprivileged Children and the Real Price of the NEET Dream

In Kuzhumur, a village in Ariyalur district most of India had not heard of until September 2017, a seventeen-year-old named Shanmugam Anitha had spent her school career proving that the system could work for somebody like her.

She was a Dalit, the daughter of a daily-wage labourer, and a student of a Tamil-medium school. She scored 1,176 out of 1,200 in her Class 12 Tamil Nadu State Board exams. She was the only student in her district to score a perfect 100% in both Physics and Mathematics. She wanted to be a doctor. By every measure the system had ever taught her to respect, she was ready.

Then came the National Eligibility-cum-Entrance Test. In an exam calibrated to a different syllabus, in a different language, on the assumption of coaching she could not afford, she scored 86 out of 720. The cutoff she needed was 196.8. She had also, in those months, become one of the petitioners before the Supreme Court arguing that NEET violated equality in admissions. The court declined to intervene. A few weeks later, Anitha was found dead at home.

Her case did not change the law. But it made unignorable a question the country has been answering badly ever since: what does the NEET system actually ask of India's poor, and what does it give them in return?

The economics of a dream

It is tempting to talk about NEET as if it were just a test. It is not. It is a market.

A Tamil Nadu government committee headed by Justice (retired) A.K. Rajan estimated the NEET coaching industry in that one state at roughly Rs 5,750 crore. It found that 99% of students who appear for NEET had received prior coaching, with many beginning preparation as early as Class 8.

The numbers at the top of the pyramid are blunt. A one-year NEET classroom programme at Allen, Kota's flagship institute, costs Rs 1.5 to Rs 2.5 lakh per session for tuition alone. Hostel and food in Kota add another Rs 9,000 to Rs 18,000 a month. A modest "all-in" Kota year now costs Indian families close to Rs 3 lakh.

For a household earning Rs 8,000 a month — the income reported for the family of Charul Honariya, a labourer's daughter from Bijnor who eventually cracked NEET and got into AIIMS Delhi — that figure is more than three years of total household earnings. Her case is extraordinary precisely because it should not be possible. The same is true of Santanu Dalai, the son of a daily-wage worker in Odisha who cleared the exam in 2022, and Isrita Panda, the daughter of a vegetable seller from Gajapati district, who cleared the same year.

Each of these students made it. But it is worth pausing on what making it required: in Anitha's case, it would have required the exact resources her family had been hired by other people to wash, lift, dig and clean to earn.

What the data shows — and what it complicates

The Rajan Committee remains the empirical spine of the case against NEET. It found that the share of rural students in Tamil Nadu's medical colleges fell from an average of 61.45% in the pre-NEET years to 50.81% after — a drop of more than ten percentage points within a few admission cycles, with the heaviest losses among students from Tamil-medium schools, government schools, and economically weaker families.

The coaching dependency is starker still. Of the 3,081 candidates admitted to MBBS in Tamil Nadu's twenty-three government medical colleges in 2019, only forty-eight — 1.6% — had got in without coaching. Two-thirds had needed multiple NEET attempts.

There is, in fairness, a real counter-story. A 2024 RTI response from the state's Health and Family Welfare Department showed that government school students are clearing NEET in growing numbers, with many qualifying outside the state's 7.5% internal reservation for them. Eight of the sixty-seven students who shared the All-India Rank 1 in NEET-UG 2024 came from Tamil Nadu.

Both pictures are true. The honest reading is not that NEET is uniformly anti-poor. It is that the system concentrates risk and cost on poor families to a degree richer families do not bear, and that the consequences of failure fall on those families harder than success ever rewards them.

Kota, and the weight of an entire family

Nowhere is that more visible than in Kota. More than two lakh students were enrolled in the city's coaching ecosystem in a recent academic year, the majority of them NEET and JEE aspirants. Most come from middle-class and rural backgrounds. For their families, the Rs 3 lakh annual expense is funded by loans against family land, by jewellery sold, by a parent taking a second job back home.

The toll has become national news. Kota recorded twenty-six student suicides in 2023, fifteen in 2022, and the count had climbed past a dozen again by mid-2024. A peer-reviewed study in 2026 made the link explicit: when a family has pawned what little it has to send a child to Kota, failure stops being personal disappointment and becomes a breach of obligation.

A political fight, and an inconvenient verdict

It is also why, in Tamil Nadu, NEET has acquired a political life that crosses party lines. The DMK fought the 2021 election on a clear promise to abolish the exam. When its bill seeking exemption was sent for presidential assent, it was declined; M.K. Stalin called the rejection "a dark chapter in federalism." The AIADMK has opposed NEET since J. Jayalalithaa's tenure. Even today, with TVK in government, Chief Minister C. Joseph Vijay has called for the exam's abolition.

The Supreme Court has its own answer. In Christian Medical College v. Union of India (2020), it upheld NEET as a check against capitation fees and the buying of seats in private medical colleges — a structural shield, the court reasoned, against admissions corruption.

The 2026 paper leak has made that defence harder to sustain. The same exam upheld as a shield against the rich buying seats has just been shown to be vulnerable to the rich buying questions — circulated, by some accounts, at fifteen lakh rupees per primary buyer and ten lakh further down the chain.

The view from Ariyalur

The auditorium at Ariyalur Medical College now carries Anitha's name, built at a cost of Rs 22 crore — more than her family would have earned across several generations of daily-wage work. It is a fitting tribute, and an uncomfortable one. The building stands inside the very system she had been fighting to enter when she died.

It is not that NEET shuts out India's poor entirely. The honest, harder claim is this: the exam, as currently designed, asks the poor for sacrifices it does not ask of the rich, and then punishes them more severely when those sacrifices do not pay off. The 2026 leak is not a separate scandal. It is the same architecture of inequity, exposed at a different point.

Eight years on from Anitha, the reckoning has not arrived. The exam continues. The coaching industry has continued to grow. And in villages and small towns across the country, families are still pawning gold and taking loans to send a child to a coaching centre in a city they have never visited, in the hope that the system will be fairer to them than it was to a girl from Kuzhumur.

It may yet be. But it has not earned that trust.