A decision by the Supreme Court of India to make testing for coronavirus free places an unfair financial burden on medical firms and could see a reduction in testing, already among the world's lowest, said business leaders and health experts.
The concern is that private medical firms, like many businesses in India are struggling financially, and could go under if they tested for free without financial assistance.
Kiran Mazumdar Shaw, executive chairperson of Biocon Limited, one of India's biggest biotech firms, said private institutions could not be expected to operate on credit.
"Humanitarian in intent but impractical to implement - I fear testing will plummet," Shaw said on twitter on Thursday about the court judgement.
"These are small businesses they're providing testing at cost and not profiteering. How will they pay their employees?"
The top court, responding to a public interest petition, said on Wednesday private medical institutions should be playing a philanthropic role at a time of national crisis and it would not allow a situation where India's poor could not afford a test for the virus that is quickly spreading through the country.
It said the issue of reimbursing these laboratories for running the hundreds of thousands of tests for novel coronavirus that the world's second most populous country urgently needs would be considered later on.
India has 5,734 cases of coronavirus and 166 deaths from COVID-19, the respiratory disease caused by the virus, according to the ministry of health and family welfare, reflecting a jump of 460 cases over Wednesday.
The numbers are small compared to the United States, Italy and Spain and one of the reasons is that the country is testing a narrow range of the population, doctors say.
These include people who have travelled overseas, people in contact with them and are showing symptoms, health workers with symptoms, hospitalised patients with respiratory problems and those who came in contact with a confirmed patient.
On Wednesday, 13,143 samples were tested nationwide, the government-run Indian Council of Medical Research said, well behind the 20,000 people South Korea has been testing each day from its far smaller population.
To beef up the infrastructure for screening, the government approved 56 laboratories for testing in addition to 136 government-run labs and set a price cap of 4,500 Indian rupees ($59.13) for every test.
The plan is to scale up to 20,000 tests in the next few days and eventually to 100,000 a day in the worse-case scenario.
But the court decision threatens to derail the plan to widen testing, said Shamika Ravi, a former member of the Indian Prime Minister's Economic Advisory Council and a health specialist.
"We are going to have fewer and fewer testing, and that is a very big problem right now because that is our single focus, to increase the testing capacity across the country."
The health sector like others parts of the Indian economy is struggling and in no position to offer a free ride, she said.
"There is a liquidity crunch in every business today, including diagnostics. People just don't have the liquidity to be able to undertake large, new exercises without any assurance," she said.
Of growing worry is India's financial capital Mumbai, which has reported 857 cases, the highest in the country including from its slums where even health workers are reluctant to go.
"We are seeing more medical staff either getting infected or just not showing up at work," said a city health inspector.
Following are government figures on the spread of the coronavirus in South Asia:
* India has 5,734 cases, including 166 deaths
* Pakistan has 4,072 cases, including 58 deaths
* Afghanistan has 444 cases, including 14 deaths
* Sri Lanka has 189 cases, including 7 deaths
* Bangladesh has 218 cases, including 20 deaths
* Maldives has 19 cases and no deaths
* Nepal has nine cases and no deaths
* Bhutan has five cases and no deaths