Around 30 experts, commissioned by the leading medical journal Lancet, to suggest reforms in India’s healthcare system have called for an “…integrated, citizen-centred health-care delivery system that is publicly financed and publicly provided as the primary vehicle for Universal Health Coverage, while shaping the private sector to leverage its strengths.”
Presented as a series of commentary and articles in the journal, that went online on Wednesday (January 21, 2026), the commission of experts recommends a “transition” from focussing only on professional qualifications (of healthcare workers), to emphasising provider “competencies, values, and motivations, and empowering frontline workers and practitioners of Indian systems of medicine (e.g., Ayurveda, Yoga, Unani, Siddha, and Homeopathy).” Those involved include academics from Harvard Medical School, Johns Hopkins University, Ashoka University (Haryana), Indian Institute of Public Health, and Indian Institute of Management, Bangalore among others.
The commission said that hurdles in insurance legislation needing large amounts of capital and preventing insurers and providers from incorporating integrated care principles need to be addressed. The deployment of digital technologies can catalyse many of the reforms proposed by the commission, for example to facilitate the integration of diverse, registered healthcare providers with multiple types of payers and patients, facilitating health data exchange, structured care coordination, and communication among them.
Rethinking scale in India’s healthcare
The rapid and widespread deployment of technologies, such as artificial intelligence and genomics, as well as capital-efficient technology innovations, can drive the health system towards point-of-need delivery of advanced diagnostics, preventive care, and citizen-centred care, the document noted.
“To empower State, district, and local government institutions to design and implement responsive reforms, there should be clear role definitions, enhanced financial and management autonomy, and strengthened capacities for local officials. Improving fund flow efficiency through digital tools, simplifying financial procedures, and reducing bureaucratic hurdles will enhance fund utilisation,” the commission said.
“Moving from line-item budgets to global budgets would support financial autonomy and motivate providers to deliver high-quality, citizen-centred care and, accompanied by reporting and evaluation criteria focused on health outcomes instead of inputs and outputs, would shift the culture of accounting to one of accountability and trust,” it added.
The commission said that with “WHO facing serious difficulties and the U.S. Government in retreat from global health”, India can be “an even stronger voice for the Global South and promote a more equitable distribution of power in a multipolar global order.”
Despite successive policy commitments, public expenditure on health in India remains under 2% of gross domestic product, which is below the National Health Policy target of 2.5%. Out-of-pocket expenditure, although declining, still accounts for nearly half of the total health spending, among the highest globally.
“If public health is only planned from the top down, it cannot be effective. Bringing the public into public health entails making room for people’s priorities, experiences, and opinions to influence policymaking,” Poonam Muttreja, executive director, Population Foundation of India, said in a statement.
