As the Union Budget 2026 approaches, the public health debate once again risks drifting towards new schemes rather than fixing delivery failures that have persisted for over a decade. Evidence across NFHS-5, National Health Accounts, NHM reviews, NITI Aayog assessments, CPCB data, Global Burden of Disease estimates and WHO benchmarks points to a consistent diagnosis: India’s health constraint is not intent or spending announcements, but weak delivery capacity.

The consequences are visible in routine use of government facilities—unavailable staff, missing medicines, long waits, indifferent responsiveness and avoidable referrals to private providers. Budget 2026 therefore needs to privilege structural correction over incremental expansion.

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