Public policies rarely announce their expiry date, but their timelines often signal when a review becomes unavoidable. The National Health Policy (NHP) released in March 2017 was explicitly framed around 2025. Most of its demographic, epidemiological, financing, and system-level targets were anchored to last year, with no explicit vision beyond it. With the anticipation of a newer NHP beyond 2026, it is time to assess the progress made so far. January 2026, therefore, marks a natural pause. A policy written in a pre-pandemic world must now be read in light of post-pandemic evidence.
From 2002 to 2017
The 2017 policy argued that India had undergone fundamental changes since the NHP of 2002. It highlighted four shifts. First, the disease profile was moving from maternal and child mortality towards a rising burden of non-communicable diseases. Second, the private healthcare sector had expanded rapidly, reshaping access and costs. Third, out-of-pocket expenditure had become a major driver of household impoverishment. Fourth, economic growth had created fiscal space for higher public spending on health. These observations remain largely valid in 2026. What the policy did not, and perhaps could not, fully anticipate were the scale of a global pandemic and the growing health impact of environmental and commercial forces as determinants of health.
A 2017–2025 scorecard
A situation analysis must begin with outcomes. The table below compares major targets articulated in the National Health Policy 2017 with the latest nationally-available official estimates and government-reported figures up to 2025, along with a critical appraisal of each indicator.
What the scorecard reveals
When we examine the scorecard, certain patterns become apparent. First, progress occurred where programmes were strong, and indicators were measurable, such as maternal mortality, immunisation, Kala Azar elimination, and fertility reduction. Second, stagnation followed where financial commitments lagged ambition, most visibly in public health expenditure and out-of-pocket spending. Third, ambiguity prevailed where measurement systems were weak or ill-defined, like DALYs, occupational injuries, “safe water”, and public facility utilisation. In these areas, the problem was not only implementation, but the absence of a clear accountability architecture.
Policy thrust beyond numbers
The NHP 2017 also extensively discussed strengthening clinical trial regulation, medical education reform, procurement of medical devices, quality assurance, and the establishment of high professional and ethical standards throughout the health system. These domains are critical, but they do not lend themselves to single-number comparisons. Progress here is inherently qualitative, institutional, and regulatory.
Beyond time-bound targets, the NHP 2017 articulated a broad reform agenda that was deliberately aspirational and structural, rather than numerically auditable. It spoke of addressing tobacco use, substance abuse, and behavioural risks through intersectoral action; of generating a Swasth Nagrik Abhiyan as a social movement for health; and of strengthening community-level platforms such as Village Health, Sanitation and Nutrition Committees. These directions recognised that many determinants of health operate outside clinics and hospitals. By design, such interventions resist quantification to measure progress. Similarly, the policy’s emphasis on a continuum of care linking preventive, promotive, curative, rehabilitative, and palliative services was a systems ideal rather than a countable output. Even frameworks that appear measurable, such as the Indian Public Health Standards (IPHS), reveal this limitation. Although IPHS was revised as recently as 2022, the standards were never given statutory or enforcement authority; compliance remains administrative rather than legal. In areas such as women’s health, gender mainstreaming, and response to gender-based violence, the policy marked an important normative shift. Still, these outcomes are shaped by social, legal, and cultural institutions that extend well beyond the health sector, making purely numerical assessments both insufficient and misleading.
The policy also outlined an ambitious institutional and workforce agenda, where follow-through has been uneven. It envisaged a unified emergency response system, 1 per 30 lakh population in urban areas and 1 per 10 lakh in rural areas. By 2025, no such population norm–based national architecture exists. Instead, emergency response continues largely through the 108/102 ambulance services under the National Health Mission, which provide wide geographic coverage but fall short of the integrated, standardised emergency system envisioned in the policy. In tertiary care expansion, progress has been clearer: the creation of AIIMS-like institutions under the Pradhan Mantri Swasthya Suraksha Yojana represents a tangible institutional achievement. Medical education reform, however, illustrates persistent structural tension. While NEET has standardised entry across undergraduate, postgraduate, and super-speciality levels, concerns around eligibility thresholds, negative marking, and workforce alignment remain unresolved. The policy’s intent to strengthen Family Medicine as a backbone of primary care has translated weakly into capacity. By 2025, only 22 MD Family Medicine seats were listed nationally in the NEET-PG seat matrix, despite a near doubling of total postgraduate seats over the same period. Proposals to create career bridges for ASHAs into nursing and paramedical roles remain largely constrained by State control, limiting Union-level reform. Most notably, despite guidance and consensus-building efforts, a dedicated public health management cadre had not been uniformly established by 2022. Finally, while the policy envisioned a stronger health system intelligence, like tracking the cost of care, utilisation, and financial protection, the absence of an updated population census continues to weaken the very data foundation required to operationalise these reforms.
What the next policy must add
Two additions are now unavoidable. First, pandemic preparedness must be treated as routine public infrastructure by building surveillance systems, laboratories, oxygen systems, logistics, and credible communication, rather than relying on emergency improvisation. Second, commercial and environmental determinants of health must take centre stage in policy thinking. Tobacco, ultra-processed foods, air pollution, heat stress, floods, and water insecurity now shape disease patterns as decisively as microbes once did. Alongside a new National Health Policy, there is also a strong case for updating the National Mental Health Policy, framed in 2014, for an era of constant internet connectivity, infinite digital feeds, blurred work–life boundaries, and rising psychological distress.
The National Health Policy 2017 set a clear direction and measurable milestones. By 2026, India had advanced on several fronts, missed others, and encountered risks that were not fully imagined in 2017. The lesson is not that targets were misplaced, but that programmes, financing, and measurement must move together. That is why this is the right moment not to abandon the policy’s vision, but to recalibrate it for the decade ahead with clearer metrics, stronger institutions, and a broader understanding of what truly determines health.
(Dr. C. Aravinda is an academic and public health physician. The views expressed are personal. aravindaaiimsjr10@hotmail.com)
