An unlicensed doctor in the northern Indian state of Uttar Pradesh has been accused of infecting 46 people with HIV, the virus that causes AIDS, by administering injections using the same syringe for nearly a year.

Police on Wednesday arrested Rajendra Kumar Yadav, who provided cheap door-to-door medical services to poor villagers in the state's Unnao district. A criminal complaint has been filed against him.

Untrained doctors thrive in Indian cities and villages due to a shortage of qualified practitioners and expensive treatment costs. The Indian Medical Association estimates that nearly half the people in India who practice medicine have no formal training.

"All these 46 cases are from specific localities within our district. This is when we decided to dig deeper," Unnao's chief medical officer, SP Choudhary, said.

"When we asked these patients whether they had used common syringes, some of them told us about a doctor they went to who uses the same syringe on all his patients," said Choudhary.

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Injections for cold and cough

But Choudhary said he doubted the man, who administered injections to treat common ailments such as colds and coughs, was the only cause behind such a high number of cases.

"We don't think that the quack doctor alone could be a factor for these numbers," he said. "The area has a high migrant trucker population, and the prevalence of unprotected sex could be the likely reason."

The HIV-positive patients are being given free treatment in a government hospital in neighboring Kanpur.

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Neglected healthcare system

The case in Unnao has exposed India's neglected and underfunded public health care system.

India, with a population of over 1.2 billion people, just spent about 1.4 percent of its gross domestic product (GDP) on health care in 2014, among the lowest in the world, according to the World Bank. In contrast, China spent 3.1 percent of its much higher GDP.

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Last year, more than 60 children died in five days in a government-run hospital in the city of Gorakhpur, also in Uttar Pradesh, India's most populous state. Most of the deaths were blamed on a lack of oxygen supply, which was cut off due to non-payment of bills.

The tragedy was followed by the deaths of at least 49 children in over a month in another government hospital in Farrukhabad district in the state, again allegedly due to a shortage of oxygen.

The Indian government earlier this month unveiled an ambitious health insurance scheme to cover about half a billion poor Indians.

But implementation of the ambitious scheme, many details of which are yet to be worked out, could prove to be a challenge in India, which has an unenviable record in implementing public schemes.

ap/sms (Reuters, AFP)