Undermining India’s primary healthcare missions

• India’s 2026-2027 budget prioritizes tertiary healthcare and high-tech facilities over essential primary health infrastructure.
• Real growth in health sector spending is barely 3% after inflation, with a marginal decline in the health sector's share of the total budget.
• Flagship primary health programs, including the National Health Mission and family welfare schemes, see stagnant or reduced nominal funding.
• The strategy favors private sector participation and medical tourism over addressing systemic shortages in rural doctors, nurses, and maternal health services.

Budgetary Disconnect

• Total health allocation rose from ₹99,858 crore (2025-26) to ₹1,06,530 crore (2026-27), but this fails to account for inflation or the urgent needs of the foundational health tier.
• Centrally sponsored schemes saw only a negligible nominal increase, failing to provide a boost for primary health centres (PHCs), community health centres, and sub-centres.
• The government's plan to train 100,000 allied health professionals over five years is insufficient, as it does not address the WHO-estimated shortage of 6.5 million health professionals in India.

Neglected Priorities

• Maternal health, child nutrition, and immunisation drives—the bedrock of public health—remain under-resourced despite their importance to India's demographic dividend.
• While customs duty exemptions for 17 life-saving drugs were announced, the budget ignores the broader issue of medicine affordability, which currently accounts for 70% of out-of-pocket health expenditures.
• The shift toward digital initiatives and AI-enabled institutions is criticized as inaccessible to rural populations lacking digital literacy and infrastructure.

Economic Implications

• India’s total public health expenditure remains significantly below the target of 2.5% of GDP.
• Misplaced priorities, such as focusing on specialized urban hubs over primary systems, threaten long-term social development, maternal and infant mortality rates, and overall health equity.