A public health network has urged the Union government to double its annual health outlay, saying the Centre has reneged on its 2017 pledge to raise public health expenditure to 2.5 per cent of the gross domestic product (GDP) by 2025.
Days ahead of the Union budget for 2026-27, the Jan Swasthya Abhiyan (JSA), a network of doctors, economists and health advocates, said government figures showed the Centre’s health spending had stagnated at 0.29 per cent of the GDP.
The Union health outlay must rise to at least 1 per cent of the GDP for the country’s total public health spending — including that by states — to reach 2.5 per cent, the JSA said. This requires the Centre’s health allocation to increase to about ₹3,50,000 crore from roughly ₹1,00,000 crore in 2025-26.
“We’re aware it is unrealistic to expect such a big jump within a year — we’re asking for at least a doubling of the Centre’s outlay for health to something like ₹2,00,000 crore for 2026-27,” said Indranil Mukhopadhyay, a health economist and JSA co-convenor.
Successive governments at the Centre have, over the past two decades, acknowledged the need to increase public spending on healthcare, but none imparted the momentum experts say is required to meet the 2.5 per cent of the GDP target.\
Union and state government spending on health as percentage of the GDP. (Powerpoint presentation by the Jan Swasthya Abhiyan)
The Narendra Modi government, in its 2017 National Health Policy document, set a goal of raising government health expenditure from 1.15 per cent to 2.5 per cent of the GDP by 2025. But spending remains at an “alarmingly low” 1.2 per cent, the JSA said in a statement on Wednesday.
“India is one of the world’s champions in public underspending on healthcare — it has among the lowest levels of public health expenditure as a share of GDP,” said Jean Dreze, a development economist. “These points have been made before, but we have to repeat them because the situation is not changing,” he said at a JSA briefing.
In 2022, Dreze said, India’s public expenditure on health stood at 1.3 per cent of the GDP, lower than 1.9 per cent in sub-Saharan Africa, 2 per cent in West Asia and North Africa, 2.8 per cent in East Asia, 4.1 per cent in Latin America and 8 per cent in the European Union.
Persistent low budgetary allocations have left India’s public health system under severe strain, particularly at the primary healthcare level in both rural and urban areas, said Ravi Duggal, a Mumbai-based social science researcher. Health facilities suffer from inadequate infrastructure, he said, while shortages of human resources are among the most critical gaps.
Government data illustrate the scale of the problem. Union health ministry statistics released in 2024 showed that community health centres in rural areas faced a 79 per cent shortfall of specialists — including physicians, surgeons, obstetrician-gynaecologists and paediatricians — with just 4,413 specialists in place against a requirement of 21,964.
India’s low public spending on health also stands out in international comparisons. Countries such as Thailand and Malaysia spend at least 10 times more per capita on healthcare, the JSA said, contributing to stronger public health systems and broader access to care.
Beyond higher funding, the network has also called for upgrades to government primary healthcare clinics, expansion of urban public health services, and guaranteed access to essential medicines and services at all levels of care.
The group said the health and education cess — introduced in 2018-19 as an additional 4 per cent levy on income tax — has failed to supplement public health spending. Instead, it has been used to offset cuts in the core health budget. Excluding the cess, Union health allocations declined by about 22 per cent in real terms between 2020–21 and 2023–24, the group said.