OPINION | India’s health needs are changing; our policies must too

It is a moment to acknowledge the scale of India’s health transition and respond with foresight.

India’s healthcare system is at a critical inflection point. While the country continues to manage infectious diseases, it is simultaneously confronting a rapid and sustained rise in non-communicable diseases (NCDs) such as diabetes, cardiovascular ailments, cancer and chronic respiratory conditions. These diseases already account for nearly two-thirds of all deaths in India, and by 2030, close to 75 per cent of mortality is expected to be NCD-related.

The economic implications are profound. The decadal cost of NCDs in India is estimated at nearly USD 6 trillion, yet the country remains structurally underprepared for this transition. India today carries almost 25 per cent of the global disease burden with less than 2 per cent of total global health expenditure—public, private and out-of-pocket combined.Despite this shift, much of our health system continues to be designed around episodic care rather than long-term disease management, prevention and risk pooling.

The Limits of Incremental Reform

Public programmes such as Ayushman Bharat and PMJAY have played an important role in expanding access, but significant capacity gaps persist, particularly in diagnostics, specialist services and advanced care beyond metropolitan centres. Long-term capital constraints, uneven infrastructure distribution and rising costs continue to challenge healthcare providers, especially MSMEs that form the backbone of service delivery. As demand steadily expands across Tier 2 and Tier 3 regions, incremental interventions will no longer suffice.

The Union Budget 2026–27 therefore presents a vital opportunity to realign India’s health policy with its emerging disease profile and economic realities—placing prevention, sustainable financing and capacity creation at the heart of reform.

Healthcare as Strategic National Infrastructure

A foundational step in this direction is recognising healthcare as strategic national infrastructure, with access to long-term financing of 15–20 years at affordable rates. Given the sector’s capital-intensive nature and long gestation periods, this is essential to support the expansion of hospitals, diagnostics and emergency care facilities, particularly outside major cities.

Equally critical is the need to address the financing challenge posed by NCDs without placing additional strain on public finances. India must begin building long-term resilience by creating dedicated funding mechanisms for chronic disease prevention and management. Earmarking a portion of the health cess and universal CSR obligations into a professionally governed public trust to combat this incoming health tsunami and create an NCD resilience fund would enable targeted investment in prevention, early diagnosis and long-term care, while strengthening the financial sustainability of the health system.

Making Prevention Actionable

Prevention must also shift from being aspirational to actionable. Making preventive health a household priority requires clear incentives. Granting a tax deduction for preventive check-ups—up to a defined annual threshold such as ₹10,000—and linking this benefit to uploading reports against an individual’s ABHA ID within the ABDM frameworkcan encourage early detection while serving as a strong trigger for digital health adoption. Over time, anonymised population-level data can strengthen disease surveillance, public health research and AI-enabled early warning systems.

Diagnostics will be central to this preventive shift. Investing in a national network of NABL/ISO-accredited reference laboratoriescan significantly enhance diagnostic accuracy, standardisation and early detection across regions, strengthening both preventive care and long-term disease management.

India’s Global Health Ambitions

Cancer care, in particular, demands urgent attention. Making advanced radiation therapy affordable by reducing the nearly 35 per cent customs duty and GST burden on high-end equipment such as LINACand proton therapy systems would significantly expand access beyond metropolitan centres. India requires close to 7,500 LINAC machines as per global benchmarks but has installed barely a fraction of this need. Aligning this step with the government’s earlier efforts to make cancer drugs affordable would be a natural and impactful extension of cancer care policy.

As India looks outward, its healthcare ambitions must also extend globally. Strengthening healthcare innovation through structured pilot programmes can help promising technologies move from proof-of-concept to real-world scale. At the same time, a committed push to Medical Value Travel through a sustained ‘Heal in India’ initiative can expand India’s international healthcare footprint, positioning the country as a trusted destination for high-quality, affordable care while generating economic value and skilled employment.

The Way Forward

India’s healthcare challenges are no longer confined to access alone; they are fundamentally about preparedness, financing sustainability and long-term resilience. The transition from episodic care to prevention-led, digitally enabled and financially robust healthcare is no longer optional—it is imperative.

The Union Budget 2026–27 is more than a fiscal exercise. It is a moment to acknowledge the scale of India’s health transition and respond with foresight. Thoughtful investments and structural reforms today can protect millions of lives, reduce future economic loss and ensure that India’s healthcare system evolves in step with the needs of its people and its economy.

(Ameera Shah, President – NATHEALTH and Promoter & Executive Chairperson, Metropolis Healthcare Limited.)

Views are personal and do not represent the stand of this publication.