Health care: Innovations for an inclusive future

India's health care sector is experiencing unprecedented growth, driven not just by rising incomes, but also through a confluence of transformative factors. As people’s financial resources expand, their demand for a broader range of services, including health care, inevitably increases. This surge in demand is also driven by an evolving landscape, rising health insurance coverage, uptick in lifestyle-related diseases, a growing elderly population, heightened health awareness and the expanding reach of services--often delivered directly to people’s homes. On the supply side, the sector is undergoing a revolutionary transformation, spurred by government initiatives, technological breakthroughs and increased private-sector investment.

As India ambitiously strives toward universal health coverage, innovation stands at the forefront of this effort, promising to enhance both affordability and accessibility. To address the current gaps in the health system, disruptive innovations are required. Fortunately, the sector has been a dynamic arena for cutting-edge advancements, with rapid developments across diagnostics, therapeutics, medical devices, genomics, and digital health. India’s vibrant ecosystem of entrepreneurs and skilled professionals plays a pivotal role in driving these innovations. By fostering supportive government policies, India has the potential not only to improve health care for its citizens but also to set a global benchmark for affordable, high-quality care.

In the last few years, several innovations in the health sector have become a part of our daily lives, improving access to medical care and reducing costs. Telemedicine is enabling patients to communicate with health care providers remotely, offering convenience, saving time, and fast-tracking processes. It is also bridging the urban-rural divide and addressing the shortage of medical specialists. Another example is a Delhi-based startup that is reshaping cardiac care with a low-cost portable ECG device. The device, priced at just ₹4,000 after discounts on popular e-commerce platforms, has minimal operating costs and allows clinics to offer ECGs for free as a point-of-care (PoC) diagnostic test.

Indian pharmaceuticals have also impacted global health care, as with a skilled workforce and competitive costs, India has become a major supplier of quality generic drugs worldwide, helping in the treatment of HIV/AIDS, tuberculosis and cancer.

India has also excelled in scalable digital health models, which gained prominence during the Covid-19 pandemic. We rapidly developed and deployed vaccines, launching the world’s largest immunisation program in January 2021. Using the Co-WIN app, India administered over two billion vaccines in 18 months, showcasing its efficient digital infrastructure. Co-WIN enabled vaccination at an astonishing rate, at one point vaccinating 14,000 people per minute, surpassing the combined efforts of the United States, Brazil, Indonesia, and Japan. The e-Sanjeevani portal of the health ministry is another notable example of digital health, having served over 27 crore patients across India to date.

The advent of IoT devices has increased the potential for health sector innovations. Health status and vital parameters of individuals can be monitored remotely, reducing costs, ensuring timely interventions, and improving the effectiveness of treatment. Similarly, Artificial Intelligence (AI)/machine learning (ml) is leading to more accurate and faster diagnostics and better health outcomes.

Partnerships between academia, industry, and government have shown remarkable results--IIT Roorkee developed a low-cost portable ventilator in collaboration with AIIMS, Rishikesh, to save the lives of Covid-19 patients. Similarly, scientists at the Dr APJ Abdul Kalam Missile Complex, RCI, DRDO-Hyderabad, made a portable and low-cost ventilator, Deven to address the requirement for many ventilators during the pandemic. The Bureau of Indian Standards recently sanctioned 82 research and development projects for faculty members of Indian Institutes of Technology and National Institutes of Technology, focusing on cutting-edge domains such as AI, blockchain, medical devices, renewable energy, sustainability, smart cities and digital transformation.

While there are several success stories, India can, and should, do more to leverage its huge potential and address large needs in the health sector. The government has to play a bigger role as a catalyser, in scaling the speed and scope of innovations. Four areas need urgent attention:

* Policy and regulatory support: There is a need for a rationalised regulatory system that classifies health care facilities based on complexity and risk. Approvals can be streamlined based on specific parameters for both smaller clinics, nursing homes and health care applications, as well as larger facilities, hospitals, complex devices and procedures. A one-size-fits-all approach overwhelms the system, delays approvals, and distracts attention from critical issues. We also need to shift focus from process-heavy regulations to outcome-based ones, measuring the success of facilities by patient satisfaction, infection rates, and adherence to best practices, while allowing flexibility in achieving these outcomes.

* Funding and investment: The current funding for the health sector is abysmally low, even though India’s public health expenditure as a percentage of gross domestic product (GDP) increased from 1.2% to 1.8% between FY2015 and FY2023. The National Health Policy (2017) aims to raise this to 2.5% by 2025, focusing on preventive and primary health care, financial protection at secondary and tertiary levels, and free drugs, diagnostics, and emergency care at public hospitals. The policy also encourages private sector collaboration with financial and non-financial incentives. However, the implementation of the national health policy vision has been slow. Post-Covid, it is imperative to enhance the focus on emergency care and noncommunicable diseases. The government should prioritise funding for health care infrastructure, innovation, and the skill development of medical professionals, aiming to increase health care spending to 2.5% of GDP.

* Training and capacity-building: To effectively promote innovations in the health sector, the government should focus on robust capacity building and financing support for entrepreneurs. These include offering specialised training programmes, workshops and mentorship opportunities tailored to health sector innovations, equipping entrepreneurs with the necessary skills and knowledge to navigate regulatory landscapes and commercialise their ideas. Innovation hubs and incubators can provide crucial infrastructure and networking opportunities. The government should create targeted funding mechanisms such as grants, low-interest loans, blended finance, and venture capital funds specifically for health tech startups. This support can be complemented by tax incentives for investors and co-investment programs that leverage private sector funding. Fostering a supportive ecosystem can stimulate groundbreaking advancements in health technology and improve overall public health outcomes.

* Proactively promoting innovations: To effectively identify and harness opportunities for innovations, the government can implement a multifaceted strategy that includes organising start-up challenges and competitions to showcase groundbreaking ideas and attract investment. Additionally, the government can facilitate partnerships between startups and industry players, creating procurement programmes that prioritize innovative solutions, and integrate new technologies into public services and infrastructure. Policy frameworks can support by promoting scalability, provide incentives for early adopters, and establish regulatory pathways that streamline the integration of new technologies.

India stands at a critical juncture in its health care journey, with the potential to not only revolutionise its own health care landscape but also to set a precedence for the world. The nation's commitment to innovation, combined with its rich pool of talent and entrepreneurial spirit, positions it as a global leader in delivering affordable, high-quality health care. Steve Jobs famously said “innovation distinguishes between a leader and follower” As India continues to innovate and invest in its health care sector, it will not just create a healthier nation but also offer hope and inspiration to the global community.

This article is authored by Dr Indu Bhushan, senior associate, Bloomberg School of Public Health, Johns Hopkins University and founding CEO, National Health Authority.