India's remarkable progress in public health: A story of institutional strength and people's participation
India's public health landscape is witnessing a transformative shift, marked by significant declines in malaria, tuberculosis, maternal and child deaths. This achievement is not merely a statistical triumph but a testament to the country's unwavering commitment to a results-driven approach. Union Health Minister JP Nadda, in his address at the Advancing Public Health Outcomes Forum 2025, highlighted the pivotal role of institutional strength and community engagement, emphasizing that these gains are not the result of isolated programs but a comprehensive strategy.
The battle against malaria has been particularly impressive, with a remarkable 80% reduction in incidence and a 78% decrease in deaths, propelling India from a high-burden to a high-impact phase. Similarly, tuberculosis incidence has plummeted by 21%, from 237 cases per lakh population in 2015 to 187 per lakh in 2025, surpassing the global average. Maternal mortality has also seen a substantial decline, from 130 per lakh live births in 2014 to 88 in 2025, while infant mortality has decreased from 39 to 27 per 1,000 live births. These improvements extend to under-five and neonatal mortality rates, which have decreased at a pace far surpassing global trends.
However, the journey towards a healthier India is not without challenges. The malaria assessment reveals persistent transmission in tribal, forested, and hard-to-reach areas, with emerging risks in urban pockets. As cases decline, experts caution that asymptomatic infections may go unnoticed, underscoring the need for robust surveillance. Similarly, the lymphatic filariasis report highlights gaps in post-treatment districts, particularly in urban slums, industrial belts, and migrant settlements. Uneven drug uptake, weak follow-up, and limited morbidity care threaten the 2027 elimination target, despite years of mass drug administration.
Tuberculosis, while showing improved outcomes due to expanded diagnostics, digital tracking, and newer regimens, remains a concern. Poverty, malnutrition, migration, and co-morbidities continue to fuel transmission, and disruptions in care for migrants, coupled with the growing burden of post-TB lung disease among survivors, are major challenges. The immunisation assessment, while praising strong childhood coverage, warns of gaps in adolescent and adult vaccination, data inconsistencies, and the absence of a comprehensive life-course immunisation strategy.
Despite these challenges, the government's commitment to strengthening primary healthcare remains steadfast. Nadda's vision of one Ayushman Arogya Mandir for every 2,000 people is a testament to this, with over 30,000 centers already achieving national quality certification. This comprehensive approach, driven by institutional strength and community engagement, is paving the way for a healthier, more resilient India, where the battle against diseases is not just a government initiative but a collective effort involving every citizen.
