India’s health care journey over the past decade has been defined by an expansion of access at an unprecedented scale. Flagship initiatives such as Ayushman Bharat and the strengthening of the National Health Mission have widened the reach of services, while investments in digital public infrastructure through the Ayushman Bharat Digital Mission are laying the foundation for more integrated care, with the past year seeing over 80 crore Ayushman Bharat Health Accounts (ABHAs) created signalling rapid progress in building portable health histories at a population scale. AI (Pixabay)The next frontier is to ensure that expanded access translates into trusted, continuous and good-quality care at the last mile. India’s healthcare system is increasingly confronting a dual burden, where expanding access must now keep pace with a rapidly evolving disease profile. As per a recent Lok Sabha response by the ministry of health and family welfare, non-communicable diseases account for nearly 61.8% of all deaths in India, with cardiovascular diseases alone contributing 28.1%, followed by cancers at 8.3%, chronic respiratory diseases at 10.9%, and diabetes and related conditions at 6.5%. This epidemiological shift reflects not only rising incidence but also changing lifestyle patterns, including sedentary behaviour, unhealthy diets, and increasing stress levels. A large preventive-health cohort reported that only one in four screened individuals was disease-free by age 30, falling to 7% by age 40. By the age of 40, this number drops sharply to just 7%. These findings indicate that the steepest health decline in the country now begins during early adulthood.Parallelly, assessments indicate that while India’s Government Health Expenditure increased to 1.84% of GDP in 2021–22, out-of-pocket expenditure declined to 39.4% of total health expenditure, the next phase of reform will need to place equal emphasis on quality, continuity and trust. On the supply side, as on 30 November 2025, 1.81 lakh Ayushman Arogya Mandirs had been operationalised with an expanded package of 12 services and teleconsultation facilities, which has strengthened the foundation for comprehensive primary care. These centres are also central to the government’s population-based screening programme for individuals above 30 years of age, targeting early detection of diabetes, hypertension, and common cancers under the National Health Mission.It is in this context that technology, particularly Artificial Intelligence (AI), presents a transformative opportunity. AI, when thoughtfully deployed, can augment frontline health care delivery by enabling early detection, improving triaging, and strengthening referral systems. Predictive analytics can support population-level risk identification, allowing health systems to move from reactive treatment to proactive prevention.India is already beginning to demonstrate measurable impact. PIB has reported that AI-enabled tools in TB care have supported approximately 16% additional case detection and a 27% decline in negative treatment outcomes. Digital platforms are also scaling rapidly. The national telemedicine service has crossed over 40 crore consultations, demonstrating the viability of remote care models at scale. When integrated with AI-enabled decision support and digital health records, such platforms can significantly improve continuity of care, particularly in underserved geographies where specialist access is limited. AI should be viewed as a decision-support tool that strengthens, rather than replaces, clinical judgement and frontline health workers.However, the promise of AI in healthcare is contingent on its integration into existing delivery frameworks. Technology must align with on-ground realities and be embedded within systems that communities trust. This is where grassroots organisations play a critical role, bridging the interface between public health systems and local populations. Community-based models, including mobile medical units and outreach programmes, continue to serve millions annually. These models are particularly relevant in addressing the NCD burden, where long-term management, lifestyle modification, and adherence to treatment require sustained engagement beyond episodic care. When supported by digital tools, they enable continuity through portable diagnostics, remote consultations, and digitally tracked treatment pathways.The broader policy architecture is also evolving to respond to this challenge. Under the National Programme for Prevention and Control of Non-Communicable Diseases, efforts are underway to strengthen infrastructure, expand screening, and improve access to affordable treatment. Initiatives such as free drug provision under the National Health Mission and affordable medicines through Jan Aushadhi centres are helping reduce the financial burden of long-term care. Under NP-NCD, 770 District NCD Clinics, 364 District Day Care Cancer Centres and 6,410 CHC-level NCD clinics have been set up, with a further 297 District Day Care Cancer Centres approved for FY 2025–26, and expanded tertiary facilities are improving access to specialised treatment. The convergence of public systems, technology, and community engagement reflects a broader shift towards integrated, people-centric healthcare. Yet, challenges remain. AI systems must be inclusive and representative, data privacy must be safeguarded, and digital literacy must be strengthened to ensure equitable adoption. India stands at a pivotal moment in its health care evolution. The next phase will not be defined solely by expanding access, but by ensuring that care is continuous, trusted, and responsive to emerging health needs. By combining the scale of public health systems with the precision of technology and the depth of community engagement, India has the opportunity to bring quality health care closer to every citizen.(The views expressed are personal) This article is authored by K Madan Gopal, senior public health expert, former NITI Aayog consultant and Santanu Mishra, co-founder, Smile Foundation.