India

India's One Health strategy prioritizes antimicrobial resistance given the country's position as one of the world's largest antibiotic consumers and producers, alongside zoonotic disease surveillance across its enormous and diverse livestock and aquaculture sectors.

India carries a large and rising non-communicable disease burden alongside continued infectious disease pressure, including tuberculosis, dengue, and antimicrobial-resistant infections increasingly resistant to last-line treatments. Air pollution in northern India represents one of the most severe urban environmental health crises globally.

India's federal health system gives states substantial authority over delivery, producing enormous variation in quality and outcomes between states like Kerala and Tamil Nadu and lower-resource states in the Hindi-speaking heartland. Ayushman Bharat has expanded insurance coverage significantly, though implementation quality varies widely.

Air pollution across the Indo-Gangetic Plain, driven by agricultural burning, industrial emissions, and vehicle traffic, represents one of the world's most severe and best-documented environmental health crises, with enormous associated disease burden.

India's vast and largely informal livestock and aquaculture sectors create significant surveillance and antimicrobial stewardship challenges, with antibiotic use in aquaculture increasingly tied to resistance patterns showing up in export testing and human clinical infections alike.

India faces some of the world's most severe compounding climate health risks: extreme heat affecting hundreds of millions of people, monsoon variability affecting both agriculture and water-borne disease, and coastal vulnerability across a long and densely populated coastline.

India's genomic sequencing and pharmaceutical manufacturing capacity, demonstrated at global scale during vaccine production, represents a significant health security asset both domestically and as a global manufacturing hub other countries depend on.

Expanding digital health infrastructure through the Ayushman Bharat Digital Mission, continued insurance coverage expansion, and antimicrobial resistance containment through the National Action Plan are stated current priorities.

India increasingly finances its own health system through domestic budget allocation and insurance mechanisms, though it remains an active partner for multilateral immunization, tuberculosis, and antimicrobial resistance programs.

The Global Fund, Gavi, the World Bank, the Bill & Melinda Gates Foundation, and WHO maintain significant technical and financing programs in India, alongside India's own growing role as a South-South health cooperation partner.

India's animal-human disease surveillance problem is fundamentally an interoperability problem: human health, veterinary, and agricultural data systems operate largely independently across states, making it difficult to detect cross-sector resistance and spillover signals until they've already become large-scale clinical problems.

India's scale means that solving its cross-sector data interoperability problem would produce one of the most consequential One Health implementation successes globally, but achieving it requires coordination capacity that most states are not currently staffed or funded to build alone.