The time has come to take a closer look at Bharat’s health journey — what has changed, what has improved and what still needs to be done
There was a time when the story of Indian healthcare was dominated by infectious diseases, inadequate infrastructure, shortage of doctors, high maternal and infant mortality, poor access to medicines and enormous differences between urban and rural healthcare. Today, that story is changing. India is building medical colleges and tertiary-care institutions at an unprecedented pace.
Primary healthcare is being expanded through Ayushman Arogya Mandirs. Millions of people have access to publicly funded hospitalisation under Ayushman Bharat. Digital health records, telemedicine and artificial intelligence are becoming part of healthcare delivery. Indian pharmaceutical companies supply affordable medicines and vaccines to much of the world.
The transformation is real. But it would be equally misleading to declare that India has already reached the health standards of developed nations. The more important question is this: where does Bharat stand today, and what must happen next?
From scarcity to scale
The peer-reviewed review “The Transformation of the Bharatiyan Healthcare System” published in Cureus describes Bharat’s healthcare system as a complex combination of public and private sectors that has undergone substantial transformation, while continuing to face challenges of infrastructure, workforce shortages, rural–urban disparities, financing and inequity.
That description remains relevant. Over the last decade, the scale of India’s health infrastructure has changed dramatically. According to the Ministry of Health and Family Welfare and the Press Information Bureau, more than 1.84 lakh Ayushman Arogya Mandirs had been operationalised by February 2026.
These centres are intended to take healthcare beyond treating illness and provide preventive, promotive and primary care closer to people’s homes. The scale of screening itself is enormous.
Hundreds of millions of people have been screened for hypertension and diabetes, along with large-scale screening for oral and breast cancers. This represents an important philosophical and outstanding change in Bharatiyan healthcare. Healthcare is slowly moving from “come to the hospital when you are sick” towards “identify disease before complications occur.”
That shift will become increasingly important as India ages and non-communicable diseases become a larger part of the disease burden.
Ayushman Bharat and the fight against the medical poverty
According to the World Health Organization’s India office, Ayushman Bharat represents one of Bharat’s most important steps towards universal health coverage. Its two major pillars include the Pradhan Mantri Jan Arogya Yojana and comprehensive primary healthcare through Ayushman Arogya Mandirs.
The Pradhan Mantri Jan Arogya Yojana, launched in 2018, provides financial protection for eligible beneficiaries requiring secondary and tertiary hospitalisation, with coverage of up to ₹5 lakh per family per year. The significance of this cannot be underestimated. For a poor family, a heart attack, cancer diagnosis, major surgery or prolonged hospitalisation can destroy years of savings. Health insurance therefore is not merely a medical intervention. It is also a poverty-prevention measure.
Bharat has also made considerable progress in reducing the proportion of healthcare expenditure paid directly by households. The National Health Accounts Estimates 2021–22 show that out-of-pocket expenditure had fallen to 39.4% of total health expenditure, compared with much higher levels in the past. But 39.4% is still a substantial burden. And there is another important limitation.
Hospital insurance is not the same as universal healthcare. A person may have hospitalisation coverage and still struggle to pay for outpatient consultations, medicines, diagnostics, long-term treatment or chronic disease management. The next stage of reform therefore must strengthen financial protection across the entire continuum of care, not only when a person enters a hospital.
Bharat’s digital health revolution
According to the Ministry of Health and Family Welfare, more than 86 crore Ayushman Bharat Health Accounts had been created by February 2026. Telemedicine has expanded enormously, with hundreds of millions of consultations being delivered through the public health system. This may ultimately prove to be one of India’s most important healthcare innovations.
Bharat does not have the luxury of placing a specialist hospital within a few kilometres of every citizen. But it can place a smartphone, digital health infrastructure and a trained healthcare worker within reach of millions of people. Artificial intelligence could take this even further. The Government’s Strategy for Artificial Intelligence in Healthcare for Bharat, launched in 2026, reflects the country’s attempt to use artificial intelligence for clinical decision support, screening, documentation, risk prediction and improving access to specialist expertise.
But technology should not become a substitute for doctors, nurses and functioning health systems. Artificial intelligence can multiply the capacity of a good health system. It cannot compensate for a broken one.
That distinction will become increasingly important.
Bharat: Pharmacy of the world:
If there is one area in which India already has genuine global health power, it is pharmaceuticals. According to the Government of India, India is the world’s third-largest pharmaceutical producer by volume and supplies approximately 20% of the world’s generic medicines. Indian companies supply medicines and vaccines to countries across the developing world, while the country’s vaccine manufacturing capacity became particularly visible during the COVID-19 pandemic.
Here, the vision of Prime Minister Narendra Modi ji has to be acknowledged, as India became the world leader in vaccine supply to several countries globally under his leadership. India also supplies a substantial proportion of vaccines procured through UNICEF. This is not merely an economic achievement. Affordable medicines are a public-health intervention. A country that can manufacture medicines, vaccines, biosimilars and other biological products at scale can influence health outcomes far beyond its own borders. India’s biotechnology sector is also expanding rapidly, creating the possibility of moving from being primarily a manufacturer of affordable medicines to becoming a significant developer of innovative biological products.
Medical education a major expansion
The World Health Organization’s India health workforce profile documents a substantial expansion of medical education. The number of medical colleges increased from 387 in 2014 to 731 in 2024, 3while undergraduate medical seats increased from 51,348 to more than 1.12 lakh over the same period. According to the Government of India’s 2026 health-sector data, India now has 780 allopathic medical colleges, with 118,190 Bachelor of Medicine and Bachelor of Surgery (MBBS) seats and 74,306 postgraduate medical seats.
The increase in medical colleges and training capacity represents an important step towards strengthening India’s healthcare workforce and improving access to medical education across the country. The expansion of postgraduate seats and new institutions, including multiple All India Institutes of Medical Sciences, has significantly increased the country’s training capacity. But numbers alone will not solve India’s healthcare workforce problem. The World Health Organization estimates India’s physician density at about 9.18 doctors per 10,000 population in 2022, with substantial geographical variation.
A doctor in Delhi and a doctor in a remote district is not equivalent from the perspective of healthcare access. The next challenge therefore is not simply: How many doctors do we produce? It is: Where do they practise, what skills do they possess, and can a patient in a remote district receive the same standard of care as someone in a metropolitan city?
It is not out of place to mention that medical tourism has also emerged as an important strength of India’s healthcare sector, with international patients increasingly choosing the country for affordable treatment, skilled medical professionals, advanced technology and a wide range of specialised services.
So, where does Bharat stand among developed nations
This is where we need to be honest. There is no single ranking called “best healthcare system” that can accurately answer this question. Healthcare performance has to be judged using multiple indicators — life expectancy, maternal and child mortality, financial protection, access to essential services, workforce, quality of care and health outcomes. On several of these parameters, Bharat has made impressive progress.
But Bharat has not yet reached the health-outcome levels of most high-income developed countries. The World Bank’s latest available data put India’s life expectancy at about 72 years in 2024. Japan, Australia and several European countries are above 80 years. The United Nations Development Programme’s Human Development Report 2025 placed Bharat at 130 among 193 countries on the Human Development Index.
Bharat has moved forward, but remains in the medium human-development category rather than the high human-development category. 4Similarly, the World Health Organization’s Universal Health Coverage Service Coverage Index gives India a score of about 63 out of 100 for 2021. India has made substantial progress — its score was about 30 in 2000 — but this still leaves considerable room for improvement. So the honest assessment is this: India has built many components of a modern health system, but the average health outcome of an Indian citizen has not yet caught up with that infrastructure. And that should be our next target.
What must Bharat do next?
The Cureus review on the transformation of the Indian healthcare system identified several persistent challenges — inadequate infrastructure in some regions, shortage and maldistribution of healthcare professionals, rural–urban disparities, high financial burden, fragmented care and the growing burden of non-communicable diseases. These challenges have not disappeared simply because infrastructure has expanded. The next decade should therefore focus on five priorities.
First – strengthen primary healthcare
A strong country does not measure its healthcare system by the number of super-speciality hospitals alone. It measures how effectively hypertension, diabetes, obesity, tuberculosis, cancers, mental illness and other lifestyle conditions are prevented and managed before they become expensive complications. Ayushman Arogya Mandirs must therefore become genuinely functional centres of comprehensive primary care rather than simply buildings with a signboard.
Second – spend more, but spend better
The World Health Organization reports that government health expenditure in India was about 1.8% of Gross Domestic Product in 2021–22, while total health expenditure was 3.83% of Gross Domestic Product. Increasing public spending is important. But additional money must translate into functioning hospitals, medicines, nurses, diagnostics, emergency services, public-health laboratories and accountable healthcare delivery.
Third – bridge the rural-urban divide HIRD
Bharat cannot call itself a health leader if quality healthcare depends upon a person’s PIN code. Specialists, nurses, diagnostic services, emergency care and critical-care facilities must become more evenly distributed. Telemedicine can help, but technology cannot replace the physical presence of trained healthcare professionals when a patient needs surgery, intensive care or emergency intervention.
Fourth – confront the non-communicable disease epidemic
India has moved from fighting primarily infectious diseases to fighting a double burden. tuberculosis, malaria and other infections remain important, while diabetes, hypertension, cardiovascular disease, chronic respiratory diseases and cancer are increasing. The World Health Organization identifies non-communicable diseases as a major component of India’s health challenge. Prevention must therefore become central to health policy. Air pollution, tobacco, alcohol, obesity, unhealthy diets, physical inactivity and uncontrolled hypertension cannot be treated as individual lifestyle issues alone. They are public-health priorities.
Fifth – measure quality, not just quality
Bharat has become very good at counting hospitals, health centres, medical colleges, health cards and consultations. The next transformation must be about measuring outcomes. Did the patient survive? Was the diagnosis correct? Was the infection prevented? Was the cancer detected early? Was the blood pressure controlled? Did the diabetic patient avoid kidney failure, blindness and amputation? Did the treatment improve quality of life? That is the scoreboard that ultimately matters.
The real meaning of a healthy Viksit Bharat
Bharat’s healthcare transformation over the last decade is substantial and deserves recognition. From expanding primary-care infrastructure and publicly funded hospitalisation to dramatically increasing medical education capacity, building a digital health ecosystem and becoming a global supplier of affordable medicines, Bharat has moved far beyond the healthcare landscape of a generation ago.
But celebration should not become complacency. We are not yet where the developed world is on several fundamental health outcomes. The next leap will be harder. Building hospitals is easier than ensuring quality in every hospital. Issuing health cards is easier than ensuring financial protection.
Creating digital health accounts is easier than making health records interoperable and clinically useful. Producing doctors is easier than ensuring that a child in a remote village can access a competent doctor when needed. And treating disease is easier than preventing it. Bharat’s first healthcare transformation was about ACCESS. The next must be about QUALITY.
The first was about INFRASTRUCTURE. The next must be about OUTCOMES. The first was about BUILDING CAPACITY. The next must be about BUILDING TRUST.
A truly Viksit Bharat by 2047 will not simply be a country with more hospitals, more doctors and more technology. It will be a country where where you live, what you earn and who you are do not determine how long you live or the quality of healthcare you receive. 6That is the real test of a developed healthcare system. And that is the distance Bharat still has to travel.
