'Health spending stuck at 1.15% of GDP': Calls for doubling of Union health budget for 2026

By A Representative 

Addressing media in New Delhi, advocacy group Jan Swasthya Abhiyan (JSA) representatives have called for a substantial increase in public spending on health and urging the Union government to honour commitments made under the National Health Policy (NHP) 2017. The press conference, details of which were shared through a press note, a presentation and a publicly accessible video link, coincided with the release of a demand letter endorsed by around 350 organisations and individuals from across the country.

JSA representatives said that public health expenditure in India remains far below stated policy targets. The NHP 2017 had committed the government to raise public health spending to 2.5 percent of GDP by 2025, but current expenditure stands at around 1.15 percent. JSA described this gap as alarming, particularly in the post-COVID-19 period, and argued that continued underfunding has weakened public health systems and increased dependence on private healthcare.

In its demand letter, JSA has called for Union government allocations to health in the 2026–27 Budget to be doubled, from the current level of around 0.3 percent of GDP to 1 percent of GDP within two years, in line with the NHP target for the Union government’s share of public health spending. It has also urged that overall public spending on health be increased to 3.5 percent of GDP by 2030. The alliance emphasised the need to substantially raise allocations to the National Health Mission (NHM) to strengthen and expand health services, improve Health and Wellness Centres, and ensure fair treatment and remuneration for health workers, including ASHAs and contractual staff.

JSA further demanded that at least two-thirds of the Union health budget be transferred to states, noting that states account for roughly two-thirds of total public health expenditure and are primarily responsible for delivering health services. Greater flexibility and untied funding for states was highlighted as essential for enabling context-specific planning and implementation. The alliance also called for the health cess to be used to supplement, rather than replace, core budgetary allocations for health.

Other demands included phasing out the Pradhan Mantri Jan Arogya Yojana (PMJAY) and shifting focus towards strengthening publicly provided healthcare, reviving and upgrading central government pharmaceutical and vaccine manufacturing units such as Indian Drugs and Pharmaceuticals Limited and Hindustan Antibiotics Limited, and increasing investment in research and development. JSA also stressed the need for stronger regulation of drug and medical device prices and for expanding institutions of academic and clinical excellence.

Speaking at the press conference, Indranil, co-convener of the JSA National Secretariat, said that Union government spending on health has declined in real terms since the COVID-19 pandemic, making it impossible to achieve the NHP targets. He said that while the policy promised public health expenditure of 2.5 percent of GDP, current levels remain at just 1.15 percent, and argued that doubling Union health allocations in the upcoming budget is necessary to begin closing this gap. He added that since the same government made the NHP commitments, it should now take responsibility for fulfilling them.

Richa Chintan, also co-convener of the JSA National Secretariat, said that recent budgetary trends show the sharpest cuts affecting programmes that strengthen the public health system, including the National Health Mission, the Pradhan Mantri Swasthya Suraksha Yojana, nutrition programmes and health research. She noted that NHM funds have declined in real terms by an average of 5.5 percent and that policy emphasis continues to favour private partnerships and insurance-based models such as PMJAY, despite evidence questioning their effectiveness in ensuring equitable access to healthcare. She called for doubling NHM funds, reversing privatisation trends and reviving central public sector pharmaceutical and vaccine units.

Ravi Duggal, sociologist and health researcher, drew attention to the declining share of Union health resources transferred to states. He said that Union transfers for health had fallen from nearly 76 percent in 2014–15 to about 43 percent in the 2024–25 Budget Estimates, describing this as a sign of increasing financial centralisation. He argued that this trend undermines basic health services, especially since health is largely a state responsibility, and noted that states have maintained higher levels of health spending during and after the COVID-19 period despite fiscal constraints. Duggal also referred to the NHP 2017 commitment that the Union government should account for 40 percent of public health expenditure, translating to around 1 percent of GDP or approximately Rs 3.5 lakh crore at current prices.

Economist and social activist Jean Drèze said that India remains among the lowest public spenders on healthcare globally, with public health expenditure hovering around 1 percent of GDP for decades, compared to an average of about 3 percent in developing countries. He said this prolonged under-investment has resulted in a severe deficit in public health facilities and warned that universal healthcare cannot be achieved without a major effort to address this gap and significantly improve standards in the public sector.

Concluding the press conference, JSA said that the Union Budget is not merely a financial exercise but a statement of national priorities. It argued that building a healthy and productive society requires a decisive shift towards strengthening public health systems, protecting vulnerable communities and ensuring that lack of public funding does not force people into debt or deny them access to essential healthcare.