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Union Budget 2026: Why primary healthcare deserves more funds

As pandemic memories fade, India’s health spending has slipped, putting preparedness, primary care and equity at risk

File photo of a primary health centre near Pune. (Express Photo By Pavan Khengre)

5 min readJan 30, 2026 01:56 PM IST First published on: Jan 30, 2026 at 11:58 AM IST

The Budget speech is probably being printed in the secret confines of a secluded chamber of the finance ministry. That does not, however, prevent a public health advocate expressing hope that the finance minister will be generous in her allocations to health overall and attentive to some high priority areas while earmarking funds to specific programmes.

While funding for health rose in response to the Covid-19 pandemic, it tailed off as other developmental priorities gained greater attention when the virus transitioned from a fearsome foe to a familiar fixture in our ecosystem. This belied expectations that the Union Budget would set the pace for health spending by states. Reaching the avowed target of 2.5% of GDP as the national health spend must still be on focus.

As pandemic threats from other microbes lurk around the corner, robust surveillance systems must be established within the framework of the One Health programme.

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Strengthen primary healthcare

Primary healthcare must receive higher levels of financing, both to deliver the array of services promised under universal health coverage and to provide the bulwark of community-based surveillance, prevention and control of both infectious and non-communicable diseases. Even if the National Health Mission changes its name and form, a thrust to strengthen both rural and urban primary health care must receive a financial fillip.

To build an efficiently functioning integrated healthcare system, district hospitals must be strengthened. Digital technologies that extend the reach and enhance the efficiency of bidirectionally connected referral services and provide tele-health, must be prioritised through enhanced allocations to the digital health mission. As artificial intelligence blends with human skills, especially in delivering human-sensitive healthcare, gaps in numbers and skills of the health human workforce must be addressed through a Human Resources For Health Mission.

Budgeting for healthcare professionals

Even as health systems must adapt to the changing nature of health challenges, so should health budgets. As numbers of the elderly rise, health services must become more responsive to their treatment and care needs. As non-communicable diseases, mental health disorders and disabilities demand more attention than in the past, primary care must focus on prevention, early detection, effective home or community-based care and appropriate referral when needed. To ensure that this expanded agenda of primary care is adequately addressed, the number of ASHAs and multipurpose health workers at frontlines must be doubled. Increased employment in primary care benefits the economy too.

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Paradoxical situation of shortages in the availability of doctors in some states, despite increased production and even ‘unemployment’ in others, must be corrected by creating a central pool of doctors who can be deployed to districts experiencing shortages or public health emergencies. Family Medicine must be incentivised in postgraduate education and employment in health services, while public health cadres must be created in all states with central support.

The Ayushman shield

Apart from improving service coverage across the country, financial protection must be ensured for those who access care. PMJAY must extend coverage across all population groups and ensure more accredited hospitals are available to ensure assurance of quality care in currently underserved areas. Healthcare financing must progressively move towards a ‘single payer’ system which operates on a ‘capitation’ mode of provider payment. The budget can catalyse that process by initiating reforms in central health services and Union territories.

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Ensuring drug safety through effectively enforced regulatory measures, that extend from production to marketing, is of utmost importance. Drug testing laboratories must be expanded in number and enhanced in quality. A national network of testing laboratories must be established drawing together public and private sectors, universities and research institutes.

Nutrition, water, sanitation, clean air and pollution control programmes must be energised by the exchequer. Higher taxes must be levied on ultra-processed foods and sugar sweetened beverages, as recommended in the Economic Survey 2025-26. Heat Adaptation Plans must be designed and adopted for urban and rural areas which will be subjected to scorching heat waves unleashed by climate change.

Will these prosaic expectations be met when the Finance Minister eloquently concludes her poetically embellished budget speech?

(K. Srinath Reddy is Chancellor of the PHFI University of Public Health Sciences and Chair of the Centre for Universal Health Coverage at the Indian School of Public Policy)