India faces both opportunities and significant challenges as it strives to meet SDG 3 targets of “ensuring healthy lives and promoting well-being for all at all ages” by 2030, and halving premature mortality by 2050, in line with the recently released Lancet Commission’s Global Health 2050 report. Although India has undertaken ambitious initiatives to improve healthcare coverage, infrastructure gaps, rising non-communicable diseases (NCDs) and unequal access to services continue to complicate its efforts.
Universal Health Coverage (UHC) is a foundational goal under SDG 3, with India’s Ayushman Bharat initiative—launched in 2018—representing one of the steps toward achieving this objective. The programme aims to provide free health insurance for India’s masses through the Pradhan Mantri Jan Arogya Yojana (PM-JAY) and improve primary healthcare via Health and Wellness Centers (HWCs). According to recent data, however, around 40% of rural areas still lack access to these essential health services, reflecting enduring regional and rural-urban disparities. About 86% of medical visits in India come from rural residents, most traveling over 100 km for care and paying 70-80% of costs out-of-pocket. Additionally, despite Ayushman Bharat’s efforts, a 2024 government report highlights that out-of-pocket health expenses remain high at nearly 40%, indicating the need for stronger financial protections to prevent impoverishment due to medical costs, in addition to strengthening the public health care system.
In maternal and child health, India has made progress, evidenced by recent findings from the National Family Health Survey (NFHS-5), which show a decline in the maternal mortality rate (MMR) from 130 per 100,000 live births in 2014 to 97 in 2020. Government programs such as Janani Suraksha Yojana have contributed to these improvements by incentivising institutional deliveries and improving maternal care, but inequalities persist. States like Uttar Pradesh and Bihar, which have higher mortality rates, require additional resources and targeted interventions to bring these numbers in line with the 2030 target of reducing MMR to 70. Achieving equitable maternal health outcomes will require addressing state-specific resource limitations and focusing on rural healthcare infrastructure.
Non-communicable diseases (NCDs) like cardiovascular disease, diabetes and respiratory illnesses (with air pollution hitting all time highs during the current season, Delhi’s Chief Minister Atishi called northern India’s pollution crisis “a medical emergency”, urging urgent action) represent an increasing threat to India’s public health. NCDs now account for over 66% of all deaths and 22% of premature deaths in India. The National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) aims to counter these trends through preventive screenings and lifestyle interventions at Health and Wellness Centres (HWCs). However, limited awareness, especially in rural areas, and inadequate access to early diagnosis impede progress. According to the Indian Council of Medical Research (ICMR), NCD-related deaths could potentially be reduced by 20% by 2030 if preventive healthcare investment is scaled up alongside public health campaigns promoting healthier lifestyles.
Pandemic preparedness and control of communicable diseases have also gained priority, especially following the COVID-19 pandemic. India’s response has led to advancements in disease surveillance, including the strengthening of the National Centre for Disease Control (NCDC). Despite these improvements, India still struggles with tuberculosis (TB), a disease responsible for more than 26% of the world’s cases, with rates highest among economically vulnerable populations. Although the government has set an ambitious target of eliminating TB by 2025, current data indicates significant challenges remain. Public health experts argue that achieving this goal will require further investments in integrated health systems and extensive outreach in communities where TB is most prevalent.
Mental health is another key component of SDG 3, and India has taken steps to address this with the Mental Healthcare Act of 2017. However, mental health resources remain inadequate, particularly in rural areas where access to specialists is limited. Data indicates that there is only 0.75 psychiatrists per 100,000 individuals, underscoring the critical shortage of mental health professionals. Expanding access through HWCs under Ayushman Bharat could potentially improve mental health care access, yet societal stigma and lack of awareness still hinder progress in mental health outcomes, highlighting the need for robust public health campaigns and mental health education.
To meet the Lancet Commission’s 2050 goal of halving premature mortality, the Global Health 2050 report emphasizes investing in health systems and addressing 15 priority conditions, including cardiovascular diseases, tuberculosis, and neonatal health. In India, gaps in managing infectious diseases and NCDs, particularly neonatal health and tobacco-related illnesses, require urgent focus on structural inequities.
Addressing these through health system strengthening and preventive care should be prioritised. India’s National Health Policy 2017 aims to increase public health spending to 2.5% of GDP by 2025, yet actual spending remains much below this target – hovering between 1.4-1.8% of GDP. Increasing allocations for primary care, preventive health services and rural healthcare infrastructure is essential to advancing public health outcomes. Additionally, health experts stress that addressing social determinants—such as clean water access, nutritional security and environmental health—will be crucial to achieving long-term resilience.
India’s efforts towards SDG 3 and the 2050 mortality reduction goals demonstrate a strong commitment, though challenges remain. Initiatives like Ayushman Bharat mark significant strides in healthcare accessibility, but chronic underspending and budgetary constraints in the Indian health sector hinder the development of robust public health systems. A stronger focus on rural health infrastructure, preventive healthcare and social equity is necessary to fulfil the ambitions of these health goals. Integrating health with broader socio-economic policies and increasing investment in public health systems will be essential to ensure that India’s progress is inclusive, sustainable and resilient against future health challenges.