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A bright future for India’s defense industry?

The stars might be aligning for India’s defense sector. Here’s what the government and industry can do to seize the moment.

Brajesh Chhibber and
Rajat Dhawan

India’s defense industry, which has grown

will have to learn to manage some uniquely

substantially in recent years, seems headed for

Indian requirements.

even better days. Growth in domestic demand should continue to be robust, the government has

To build tomorrow’s industry, India’s Ministry

a clear vision for an indigenous defense indus-

of Defence and its contractors might look to

try, the country’s attractiveness to global defense

mature markets such as France and the United

companies is rising due to shrinking global

Kingdom, as well as to developing markets

defense budgets, and there is tremendous export

such as South Korea, and apply some of the ideas

potential in engineering services and compo-

pioneered there. One essential move is to decide

nent sourcing.

on core capabilities and focus efforts on building these in India. Other steps include improving

The way forward is not without some signifi-

the talent market, building skills in the govern-

cant obstacles, however. In particular, the

ment and private companies, and ensuring

government’s new purchasing procedures must

open and inclusive access to defense markets.

prove their mettle, and broadening and shifting the nation’s strategic alignments will be

If the government and its partners embrace the

challenging. For their part, defense firms

challenge, India in 2020 will have a vibrant

A bright future for India’s defense industry?

45

industry capable of meeting not only its domestic

noncompetitive, bilateral agreements. These

needs but also the needs of other nations. That

accounted for approximately 70 percent of

would give India a greater degree of self-reliance,

the total from 2000 to 2010. India increasingly

of course, and contribute to a stronger trade

looked beyond its traditional supplier, Russia,

balance and substantial job creation.

for weapons procurement and began to include

Neil Webb

France, Israel, the United Kingdom, and
A decade in review

the United States in the mix. However, even with

India’s defense market saw robust growth over the

increased purchases, equipment levels in

past decade. Government capital spending

several key categories have declined over the last

quadrupled from $3 billion in 2000 to $12.2 billion

decade due to rising obsolescence and delayed

in 2010.1 By this measure, India was the sixth-

procurement (Exhibit 1).

biggest spender on defense worldwide from 2000

McKinsey on Defense 2013 to 2010.
India defense
Exhibit 1 of 6
Most capital spending was done through intergovernmental purchases, which are typically

Exhibit 1

These intergovernmental purchases often include

are licensed to produce the contracted equip-

a significant role for defense public-sector undertakings (DPSUs)2 —Indian companies that

Inventory has declined for several platforms.
Count of equipment

2000

Some platforms have seen growth . . .

. . . while others are being depleted

Tanks
(Army)

Fighters
(Air Force and
Navy)

2011

Surface combatants1 (Navy)

Attack helicopters (Air Force)

155 mm howitzers (Army)

4,117
3,414

21%

758
646

–15%

410
310

21

1 The

23

–24%
32

10%

surface-combatants category includes destroyers, frigates, and corvettes, but not submarines.

Source: The Military Balance, The International Institute For Strategic Studies, 2000 and 2011 editions

20

–38%

46

McKinsey on Government Spring 2013

McKinsey on Defense 2013
India defense
Exhibit 2 of 6

Exhibit 2

The Defence Procurement Procedure, or DPP, guides standard procurement.
Indian defense purchasing includes 3 components
Description
1 Standard procurement (DPP)

Requirement

Forms the basis of most capital purchases to ensure the best quality at the lowest price



Includes 4 types of contracts1: buy, buy and make, buy and make (Indian), and make



2 Intergovernmental agreement •

Upgrades are available to get classified in 1 of the above categories



Includes procurement from friendly countries for geostrategic advantage and based on intergovernmental agreement:



Indigenous content can offset requirements in other contracts



Not required to meet DPP



Deals could be negotiated to include offsets for DPP

– Equipment purchases that benefit Indian armed forces but are based on suppliers’ contracting practices
– Procurement of in-service platforms
3 Strategic deals



Includes procurement driven by strategic partnerships or major diplomatic, political, economic, technological, or military benefits

1 “Buy”

includes equipment purchases that are put to a tender that is either global or limited to Indian vendors. In “buy and make,” a contract is awarded to a foreign vendor; some procurement is from outside India, but equipment is produced or manufactured in the country. In “buy and make (Indian),” a contract is awarded to an Indian vendor; some procurement is from outside India, but equipment is produced or manufactured in the country. In “make,” systems are designed, developed, and produced indigenously.
Source: Defence Procurement Procedure, 2011, India Ministry of Defence; McKinsey analysis

ment. For example, a large proportion of the

However, growing demand has attracted many

Indian Air Force’s fleet of Russian Sukhoi Su-30

new industry participants—Indian firms

MKI fighter jets was manufactured under

such as Larsen & Toubro, Mahindra, and Tata, as

license by Hindustan Aeronautics Limited (HAL)

well as global “primes” and OEMs such as BAE

in India through the transfer of designs and

Systems, Boeing, and Israel Aerospace Industries.

subsystems from the Russian original-equipment

These companies have started to build market

manufacturer (OEM). DPSUs also undertake

positions in air, land, naval, and communication

new development; they have, for example, created

systems. While this development could make

Agni and Prithvi missiles and Arjun tanks.

the industry more dynamic, it has not yet signifi-

Currently, DPSUs are the only defense firms with

cantly altered the industry’s structure, which

a sizable presence in the country, and they are

remains tilted toward DPSUs.

highly vertically integrated, a factor that weighs against the development of an elaborate base

An important development in the last decade was

of defense suppliers.

the creation of the Defence Procurement

A bright future for India’s defense industry?

47

Although progress from the Defence Procurement
Procedure was modest at first, it has picked up in recent years; approximately $4.3 billion worth of offset contracts have been signed and launched since 2007.

Procedure (DPP) in 2002; it has since seen

The next phase of growth

many revisions and amendments. The objectives

We expect India’s $12 billion defense market

of the DPP are to bring structure and

to continue its strong growth trajectory through

transparency to procurement and to build the

2020.3 By that time, capital-equipment spend-

capabilities of India’s nascent defense

ing is expected to reach between $18 billion and

industry through offset obligations—requirements

$20 billion4—the second-highest growth rate

that contractors source the equivalent of

among the top 15 countries ranked by defense

30 percent of the foreign-exchange value of the

spending. India will continue to be a large

contract from Indian defense suppliers

net importer of defense hardware; indeed, its

(Exhibit 2).

import intensity will continue to be one of the highest among countries that procure at

DPP has been in place for about ten years, and

similar levels.

though progress was modest at first, it has picked up in recent years; approximately $4.3

India’s domestic demand likely will be set by

billion worth of offset contracts have been

five factors:

signed and launched since 2007, most by India’s
Air Force. As noted, most of India’s purchases

•  hanging geopolitical scenarios on India’s
C

are from other governments and thus are not

borders may necessitate continual augmentation

eligible for DPP. That said, procurement seems to

of its defense equipment.

be shifting toward a DPP-led competitive process. The recent deal for medium multirole

•  ew procurement will be necessary to replace
N

combat aircraft (MMRCA), under negotiation

obsolete equipment and to reach inventory levels

with Dassault for the company’s Rafale jets, is a

required for combat readiness.

good example of an at-scale order (approximately $10 billion) put out for competitive bid.
While this is a good sign for the program,

•  nternal security requirements will likely drive
I
demand for homeland-security equipment.

all things considered, it is still too early to judge
DPP’s impact in driving efficiency in the procurement process.

•  trong underlying economic growth would allow
S
for increased government spending on defense.

48

McKinsey on Government Spring 2013

• The entry of new companies in the market would


largest share, driven by the need to augment the

increase competition and innovation, further

depleted strength of equipment (particularly

driving growth.

submarines and aircraft carriers) and by the new

McKinsey on Defense 2013
India defense
Put it all together, and India’s spending will total
Exhibit 3 of $150 billion5 in the short term approximately 6

Exhibit 3

marines, additional aircraft carriers, and

(Exhibit 3). Naval platforms will account for the

landing platforms.

strategic naval mandate for “blue water” capabilities, which will require nuclear sub-

Platform spending will likely total nearly $150 billion by 2017.
Potential
spending,1
$ billion
Air

Main orders expected

Combat/trainer

26.3

Medium multirole combat aircraft and other fifth-generation aircraft, Mirage upgrade, MiG-29 upgrade,
Jaguar engine upgrade, basic trainer

Support

15.8

Transport aircraft, aerial tankers, long-range maritime patrol aircraft, midrange maritime reconnaissance aircraft,
Phalcon AWACS,2 mini AWACS

9.1

Light-utility helicopters replacing Chetaks for Navy, multirole helicopters for Navy, attack, heavy lift, light utility, light combat

Rotary

Land

Fighting vehicles

15.8

Arjun main battle tank (MBT), T-90 MBT, light tank, futuristic infantry combat vehicle

Artillery

155 mm towed guns, 155 mm ultralight guns, 155 mm self-propelled tracked guns, 155 mm self-propelled wheeled guns

Missiles

3.4

Javelin antitank guided missiles, CBU-105 sensor-fuzed weapon, short- to medium-range surface-to-air missile, Agni-V, MICA

Infantry systems
Sea

4.2

1.1

Futuristic Infantry Soldier as a System (eg, weapons, helmet, visor, clothing)

Surface combatants

20.8

Aircraft carrier: Project 71; destroyer: Project 15B; frigate:
Project 17A and 17B; corvette: Project 28A

Submarines

46.7

Nuclear: Arihant follow-on, Scorpene, Project 75I, special, midget

Support
C4ISR3

1 Total

4.1

Landing platform dock, landing ship tank, landing craft utility

0.3

Navy 3-D radar, radar-jamming integrated electronic warfare systems

includes $1.1 billion of infantry equipment not detailed in the chart. warning and control systems. control, communications, computers, intelligence, surveillance, and reconnaissance.

2Airborne

3Command,

Source: Literature search; McKinsey analysis

A bright future for India’s defense industry?

49

McKinsey on Defense 2013
India defense
Exhibit 4 of 6

Exhibit 4

Offsets could spur growth.
Defense spending eligible for offsets through 2017, estimated, $ billion
150

30–60
10–20
Total spending Intergovernmental without offsets

Buy (Indian) or make

Buy and make (both)

Potential order spend eligible for offset

30%

Offset potential Source: Defence Service Estimates, India Ministry of Defence; Economic Survey 2009–2010, India
Ministry of Defence; Report of the Thirteenth Finance Commission (2010–2015); Union Budget of India,
India Ministry of Finance; McKinsey analysis

Upgrading the Indian Air Force’s capabilities will

made in July 2012, added multipliers for the offset

drive the second-largest portion of spending.

credits created in deals with micro-, small,

The Air Force plans to increase its “eyes in the sky”

and midsize enterprises and for the acquisition of

by acquiring airborne warning and control

specific technology by the Defence Research &

systems, augment its strategic and tactical lift

Development Organisation. New rules also add

capabilities by strengthening its transport

homeland- and coastal-security equipment

fleet, and acquire new fighter platforms such

to the list of eligible products and services and

as MMRCA and fifth-generation aircraft.

offer more time for contractors to bank their

Land forces are primarily looking to acquire

offset credits.

tanks, combat vehicles, and artillery, and they are building a network-centric infantry

Uniquely Indian requirements

through the Futuristic Infantry Soldier as

Taken together, these programs provide

a System program.

a significant opportunity to industry suppliers.
In addition to operational and commercial

In addition to these big procurement programs,

strengths, capturing the opportunity successfully

offset obligations under the DPP could

will require a strategy that is informed by

become an opportunity worth $10 billion to

awareness of three essential characteristics of

$20 billion for the domestic industry,

the next wave of Indian defense spending.

based on the current order pipeline (Exhibit 4).
As noted, the basic intent of the offset policy

First, in the next three to five years, most of the big

is to build a domestic defense-manufacturing

contracts announced in recent years will be

base. The most recent amendment to DPP,

awarded, providing a window of opportunity to

50

McKinsey on Government Spring 2013

McKinsey on Defense 2013
India defense
Exhibit 5 of 6

Exhibit 5

Cost savings and discharge of offset obligations will likely boost a nascent export market.
Size of dot indicates strength of factor

Growth drivers










Engineering services

Components

Cost efficiency
Talent and other factor costs are available at
50–60% of the costs in developed markets
Players can access quality components, with substantial savings on a landed-cost basis
Discharge of offset obligations
Multinational original-equipment manufacturers with Indian defense contracts can discharge their offset obligations by sourcing military-grade components and services from India
Access to engineering talent
There are shortages of engineers in multinationals’ home markets
India has a small but growing pool of qualified engineers



Stronger business outcomes
Time to market can be shortened



Increased productivity or yield could result



Waste in operations can be reduced

suppliers. This will represent an upswing in India’s

The beginnings of an export market

strongly cyclical defense demand, and it is a rare

The domestic industry seems poised for another

and perhaps unique exception to the downturn in

period of rapid growth. Moreover, India has

the global aerospace and defense market,

the potential to become an attractive destination

which many expect to persist for at least the next

for governments and companies around the

few years.

world that need engineering services and components. Collectively, these opportunities could

While Indian procurement is cyclical, it is also

total $6 billion to $10 billion by 20206 (of which

uneven—a second characteristic. Large programs

we estimate $2 billion to $4 billion will be for

are often slowed by contracting challenges.

engineering services and $4 billion to $6 billion

Smaller programs will likely move through the

for components).

process relatively quickly.
Both opportunities leverage two of India’s key
Finally, intergovernmental orders are likely to

advantages: its lower cost base for manufacturing

continue to account for most spending, although

and its small but growing pool of skilled

they may become less common.

engineers (Exhibit 5). Shrinking defense budgets

A bright future for India’s defense industry?

in Western countries and the resultant pressure

51

such as communication and navigation

on OEMs to “do more with less” could make

electronics. A few examples are already emerging

India’s low-cost manufacturing and labor services

in this field; Tata and Boeing have partnered

more attractive. And engineering-services

to produce defense-related aerospace components,

sourcing and component sourcing can be used to

and Tata and Sikorsky have teamed up to

fulfill offset obligations for multinational firms

assemble Sikorsky S-92 helicopter cabins for

that win big weapons contracts.

civil and military use.

The preferred business model for engineering

For the export dream to come true, some critical

services will likely be captive centers of

supports are needed—especially talent availability,

competence and joint ventures due to the strategic

infrastructure, and sound regulation. India

and intellectual property–intensive nature of

will have to build its stocks of aerospace and

the work. A few examples have already emerged—

defense expertise: although India is one

these include a captive unit of Safran, a French

of the world’s largest producers of engineers

defense major; BAeHAL, a joint venture between

(about 350,000 per year), only 4,000 or

BAE Systems and HAL; and an engineering-

so are aeronautical experts. In addition, the

services partnership between Rolls-Royce and

government could help pave the way for

Tata Consultancy Services.

the required infrastructure to be built quickly by putting enabling policies in place, and export

For component sourcing, India could draw on its

approvals must be more readily forthcoming.

strengths in the auto-components industry and target three sets of components: highly varied,

A third, smaller export opportunity merits

low-volume, and skill-intensive parts, such as

a mention: the chance to sell to countries with

aerostructure components and armor plates; those

requirements similar to India’s. The nation

that require a higher degree of engineering,

currently has defense-supply relationships with

especially manufacturing engineering, such as

smaller South Asian countries such as Bhutan,

complex castings, forgings, and fabricated

Nepal, and Sri Lanka. Other emerging markets

parts; and components with embedded software,

also beckon; for example, India recently

52

McKinsey on Government Spring 2013

supplied Dhruv helicopters, designed and manu-

payments for equipment imports; a vital domestic

factured by HAL, to Ecuador. The key to

industry could right this trade imbalance.

unlocking these markets is to deliver the right

And a thriving industry will create jobs in both

quality of platforms, of the right “vintage”

manufacturing and engineering services.

(that is, one, two, or three generations behind the leading edge), at a disruptive price point. It is

So the goal is worthy. But how can it be achieved?

here that India, with its record of frugal

As India sets out, it can look to other countries

engineering, could have a unique advantage.

whose defense markets were once at a similar stage of evolution and later went on to build a robust

2020: Toward a sustainable

domestic industry. France and the United

industry ecosystem

Kingdom did it some time ago; Israel and South

India is in an unusual and perhaps unique position

Korea are doing it now. Most of these coun-

to build a vibrant local defense-industry

tries made five moves.

ecosystem that could support both domestic and export demand, yielding material benefits

made explicit choices about competencies

direction. Today, the country makes huge

Exhibit 6

Choose core capabilities. Successful countries

McKinsey on Defense 2013 to the industry and the nation. Self-reliance is the
India defense sine qua non in defense, in India and elsewhere,
Exhibit 6 of 6 vital industry is a big step in that and developing a

requirements (Exhibit 6). Some of the elements

and capabilities for their domestic industry, based on their strategic needs and operational

Successful countries made explicit choices on core military capabilities to develop themselves, and they procured the rest.
Potential core capabilities
Land




Sea

Propulsion systems
Armor protection

Hull technologies
Propulsion (air-independent propulsion/nuclear) • Weapons systems
• Electronics



Air



C4ISR1



1 Command,

Aerostructures
• Propulsion (jet engines)
• Electronics
• Missiles
Communications
• Surveillance
• Network aggregation

Which strategic capabilities must be retained in-country?
• Core to defense of the country
• Require constant availability
• Will provide strategic influence

Where does the country have natural advantages?

Which capabilities will have broader benefits for local industry and job creation?

control, communications, computers, intelligence, surveillance, and reconnaissance.

Ministryof-defense domain A bright future for India’s defense industry?

53

India is in a position to build a vibrant local defense-industry ecosystem that could support both domestic and export demand.

that might guide these choices include the

to be determined on a case-by-case basis;

desired level of readiness of a country’s forces and

however, most recent proposals have been denied.

the desired vintage of weapon systems.

Defense is a strategic sector—there is none that is more so—and governments need to ensure

Accelerate capability building. Once capabilities

proper checks and balances before opening

were chosen, these countries took steps to

it up to foreign participation. At the same time,

speed up their development. One common move

India might also weigh the considerable

was to shape procurement procedures,

benefits of foreign participation, including access

in particular highly specific offset policies, to

to state-of-the-art technology, to ensure

encourage capability building in their

that the domestic industry’s desired progress

chosen domains. For India, that may mean

is not delayed.

further revisions to the DPP.
Improve procurement processes. Successful
Enable the optimal industry structure and

countries rationalized their procurement

conduct. Successful countries established a level

processes to ensure simplicity, clear account-

playing field for all industry participants,

ability, and speedy decision making.

including global OEMs, domestic private players, and government-owned defense entities.

Drive a performance orientation in government

Some did this by raising limits on foreign direct

defense entities. These countries invested in

investment. Equality of opportunity makes

their defense ministries and other groups, trans-

market participation more attractive for multi-

forming several key agencies to support the

nationals, which can invigorate the local

market’s requirements.

industry with world-class practices, processes, and technologies.

A balancing act
India’s journey to a world-class defense industry

In this context, the restriction that limits

has begun, but for the foreseeable future,

foreign ownership of Indian defense entities to

it is likely to remain one of the largest importers

26 percent could be viewed as a bottleneck

of defense hardware in the world. As such,

by multinationals, which naturally want to ensure

it is already diversifying its supplier base,

appropriate controls on the flow and use

courting countries such as France, the United

of their intellectual property by partners. The

States, and others while also seeking to

current foreign-direct-investment policy

maintain close ties with its long-term trusted

does allow for a higher ownership percentage,

supplier, Russia.

54

McKinsey on Government Spring 2013

India’s close strategic relationship with Russia

These are early days for India’s expanding network

(and earlier with the Soviet Union) was bolstered

of defense relations. The country’s move-

by its partner’s willingness to share top-of-the-

ments will be guided by changes in its geopolitical

line platforms and technologies. Over time, India

situation, especially as India builds deeper

expanded its base to countries like France and

relationships with countries such as France and

Israel, again driven by their willingness to share

the United States and sees how these countries

the desired platforms and technologies. Of

fare as trusted suppliers. These movements have

late, India has had some issues with its suppliers

the potential to spark substantial changes in India’s

related to prices, availability of spares, and

strategic relationships and ultimately in the

so on; as a result, it is again expanding its supplier

balance of trade in the global defense industry.

pool. India is now exploring possibilities

Will supply relationships with countries such

with some Western countries, particularly

as France and the United States serve to strengthen

the United States.

India’s political ties with Europe and America?

A bright future for India’s defense industry?

55

Will India emerge as a defense exporter in its own

companies chasing the opportunity. As the journey

right? What would this mean for India’s role

unfolds, it will no doubt offer useful lessons for

in the region and beyond? The next decade of

other countries at the start of their own journeys

development bears watching.

to self-reliance in defense. 1 To convert India’s accounting terms to those used elsewhere,

Already, India’s defense sector has picked up some best practices, for instance, giving initial form and shape to a structured procurement process and putting in place an offset program. The government is continually refining and reforming this procurement process and fine-tuning its requirements to reach best-in-class performance.
It is an arduous task; there is much to do and little time in which to do it. But the benefits are compelling, both for India and the defense

fiscal year 2001 government-expenditure numbers are presented as 2000 numbers; similarly, fiscal year 2011 numbers are presented as 2010 numbers. 2 Defense public-sector undertakings include BEML, Bharat
Dynamics Limited, Bharat Electronics Limited, Goa
Shipyard Limited, GRSE, Hindustan Aeronautics Limited,
Hindustan Shipyard Limited, Mazagon Dock Limited,
Mishra Dhatu Nigam Limited, and Ordnance Factory Board. 3 Estimates based on data from Teal Group Corporation and several government sources including Defence Service
Estimates, the Ministry of Defence, the Finance Commission, the Union Budget, and the Economic Survey. 4 In real terms, using constant 2010 prices. 5 Representing all known programs, including some recently ordered but not yet fully delivered. 6 real terms, using constant 2010 prices.
In

Brajesh Chhibber is a consultant in McKinsey’s Delhi office, where Rajat Dhawan is a director. Copyright © 2013
McKinsey & Company. All rights reserved.

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...uiaiuf aiusd fas d fasf aosfa sidufashfads f aius dfas af iasdifuasiuf ai usf af aisf ias fiuasdf aios fias fioas fo as fas fashf asdi fais fais fasoiduf aisodf ais fias f iads fiaisu df Hello!!skvaknvosanf fasoid osa vsap vuasn vo hsf sd fos afi asfisdfads fsadfhuas uduasd iasd a aih fia iufhfiua si fasifas ia fiasf asfafi asiuf asf iuasfiua sa s iua isaf uiaiuf aiusd fas d fasf aosfa sidufashfads f aius dfas af iasdifuasiuf ai usf af aisf ias fiuasdf aios fias fioas fo as fas fashf asdi fais fais fasoiduf aisodf ais fias f iads fiaisu df Hello!!skvaknvosanf fasoid osa vsap vuasn vo hsf sd fos afi asfisdfads fsadfhuas uduasd iasd a aih fia iufhfiua si fasifas ia fiasf asfafi asiuf asf iuasfiua sa s iua isaf uiaiuf aiusd fas d fasf aosfa sidufashfads f aius dfas af iasdifuasiuf ai usf af aisf ias fiuasdf aios fias fioas fo as fas fashf asdi fais fais fasoiduf aisodf ais fias f iads fiaisu df vv Hello!!skvaknvosanf fasoid osa vsap vuasn vo hsf sd fos afi asfisdfads fsadfhuas uduasd iasd a aih fia iufhfiua si fasifas ia fiasf asfafi asiuf asf iuasfiua sa s iua isaf uiaiuf aiusd fas d fasf aosfa sidufashfads f aius dfas af iasdifuasiuf ai usf af aisf ias fiuasdf aios fias fioas fo as fas fashf asdi fais fais fasoiduf aisodf ais fias f iads fiaisu df Hello!!skvaknvosanf fasoid osa vsap vuasn vo hsf sd fos afi asfisdfads fsadfhuas uduasd iasd a aih fia iufhfiua si fasifas ia fiasf asfafi asiuf asf iuasfiua sa s iua isaf uiaiuf aiusd fas d fasf aosfa sidufashfads...

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...Essaydasffffffffffffffffffffffffffffffffffffffffff Saf As Fas Fa Sf Saf Sa Fsa F Sa Fa F As Fa Sf As F Sa Fas F Sa Fsa F Sa F As Fas F Asf Sa Fas F Sa Fsa F As Fsa F As Fsa F Sa Fsa Fsa F Saf As Fsaf Safsafas fsa fasf a fasf asfa as fasfsafasf safa fas fsaf af asf asfasf asf asf asfasfa fas fasfsafa asfa fasfa fa fasfads fa df dsf ds f dsf s fsd f sdf sd fsd f dsfds fjsd fje kfj ewkjf ewkjf wke fkwe fkew kfj ewfkew fk ewf ewk fkwe fkjew kjf ewf ewkjf kjewfew kjf ewf ew few kjfw jewfkjew kjf ewf kjew fkew few fkjew kjfew kf ewf ewkf ewk fkew fkew kj ewkjf ewkjf ewf wekj fkjew fkew few fkjew kjf ewkf ewk fkew fkjew fekew fkew fkjew kjfew kjf ewf ewkjf kjew fkjew fkjew fkjew fkew kjfew kfewkjf kjew few fkew kjf ewkf ewf wef kewj fkwje fkew fkew kjf ewkjf ewkjf wekjf ewk fkwe fkjew fkjwe ef kjew fkew fkew kf kew fk ewf ew few few few few few few few few fwefewfwe few f ew f ew f ew f ew f ew f we f ew fewf ew f e few f ew f ewf ewf ew f ew f ew few fw ewf ew few f ewf ew f ew f ewf ew few f ew f ew f ew few few f ew few f ew f ewf ew f ew f ewf M.G. is an 8-year-old boy who has been brought to the emergency department by his parents with a fever of 104º F, lethargy, headache, and stiff neck. Laboratory analysis of a spinal tap demonstrates increased white blood cells in the cerebrospinal fluid (CSF). Discussion Questions 1. What is the most likely cause of M.G.’s signs and symptoms? What is the origin and pathogenesis? What...

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