Reimagining Public Health in the Age of Innovation

For decades, public health in India and across the globe has largely been the domain of the state - driven by policies, programs, and top-down interventions. While this approach has enabled major breakthroughs in disease control and population health, taking India’s life expectancy from just 35.21 years in 1950 to over 70 years in 2025, the causes of mortality and barriers to good health in New India are very different from those that our public health systems were designed to address.

As the domain of public health expands from addressing communicable diseases and infections through vaccination drives to tackling the problems of lifestyle disorders and taking healthcare services to the last mile, a new public health paradigm is emerging - one that is deeply rooted in innovation. This new public health ecosystem, anchored by startups, is bringing together government bodies, NGOs, research institutions, and communities to co-create solutions that are context-specific and scalable.

In this new paradigm, public health challenges are increasingly being met with entrepreneurial energy and scalable tech-driven solutions, not just by trying to scale state capacity by increasing manpower at the grassroot level. Startups across India are stepping in to bridge gaps and make public health service delivery more efficient in key sectors like improving maternal health outcomes, enabling low-cost diagnostics, or deploying AI-powered screening tools for diseases like cancer and tuberculosis. This transformation is being actively supported by platforms like Startup India, India Accelerator, BIRAC, and other venture capital firms that are acting as ecosystem enablers that not only fund but also mentor and scale health innovations tailored to India’s unique needs.

Technology is proving to be a powerful enabler for improving India’s health outcomes. Telemedicine and mobile health platforms are expanding access to care in underserved regions. AI and machine learning are revolutionizing early detection and decision support. IoT and wearable devices are enhancing real-time community-level health monitoring. Drones, cold chain tech, and supply-chain innovations are improving last-mile medicine and vaccine delivery. This innovation-driven model doesn’t replace government efforts - it complements and strengthens them to make sure the healthcare needs of over 140 crore citizens of India can be met.

In many facets of public health, India has made remarkable strides over the years. It has brought down maternal mortality from 560 in 1990 to 97 per 100,000 live births today. However, the population and geographical spread of India combined with the unique and transforming healthcare needs of individuals necessitates that technology and innovation form the core of India’s public health going forward if the rate of progress is to be maintained. Today, the leading causes of death are no longer communicable diseases, they’re instead disorders like obesity, diabetes, heart disease, cancers and alzheimers. Technological innovations by startups are revolutionising treatments and preventative care in all these areas where disease burden now predominantly lies. A startup called Sunfox Technologies has developed Spandan, a portable ECG device that facilitates early detection of cardiac issues at home or in clinics - and it has already helped over 30,000 users and prevented more than 10,000 heart attacks. Another startup, Fitterfly focuses on diabetes, obesity, and metabolic health, having managed over 50,000 patients with clinically proven HbA1c reduction of up to 1.8%. BeatO, a digital diabetes management platform, boasts over 1 million users and has processed more than 6 million blood glucose readings, reducing hypoglycemic events by 52%. Twin Health works on diabetes reversal and metabolic disease management, claiming over 90% success among enrolled users, with deployments in both India and the US. Wellthy Therapeutics addresses diabetes, hypertension, and cardiac health, supporting over 70,000 patients while improving medication adherence by 87% and halving hospitalization risk. Aindra Systems offers point-of-care diagnostic devices for early detection of cardiac and cancer conditions, performing 5,000+ tests monthly and operating in 100+ healthcare centers in tier-2 and 3 cities.

As some startups work on developing technological solutions for these new health challenges of the 21st century, others are working to solve timely diagnostics and skilled care that still continues to be a major challenge in large parts of the country, especially in rural and underserved areas. Startups like Janitri Innovations are piloting AI-powered, wearable maternal and fetal monitoring devices in primary health centers (PHCs), enabling frontline workers to detect complications in real-time, reduce delays in care, and lower out-of-pocket costs for mothers. Another startup, SpotSense offers ReaDx and ViewDx, compact diagnostic tools that deliver lab-quality results in minutes using just a drop of saliva or blood. These tools screen for neonatal conditions like jaundice, sepsis, and congenital hypothyroidism, as well as maternal health issues such as anemia, diabetes, and thyroid disorders. Such real-world deployments of technologies to address pressing public health issues demonstrates how innovation can enable informed, timely decisions at the last mile - where conventional systems often fall short. 

While it is clear that a new paradigm for public health is already taking shape in the country, it isn’t without its challenges. The success of this new paradigm requires that startups go beyond innovation for its own sake and become ethical, embedded partners in systemic change. This starts with startups understanding in depth where the challenges of public health delivery lie, and building solutions to address those challenges rather than trying to integrate technology into areas not in need of a solution. As technology becomes more critical for public health, startups would also require radical transparency in algorithms, ensuring AI tools are explainable and unbiased, particularly for vulnerable populations. Equity must also be built in from the start, with user interfaces designed for low-literacy populations, gender-sensitive features, and offline-first modes for low-resource settings. 

Innovation in this sector would often mean forgoing the most technologically advanced solution in favour of a combination of low-tech tools with deep-tech backends to augment, not replace, frontline workers. Startups must also build contextual intelligence, recognizing that health data means different things across regions and communities - something best achieved by co-designing with local health workers and social scientists. Participatory business models that empower ASHAs or enable community ownership can increase engagement and trust. Innovations should align with existing public systems, integrating with government processes and local community practices instead of aiming for radical disruptions that might never materialise. Finally, startups must also plan for ethical exit strategies, ensuring continuity of service and costs by integrations into existing systems once pilots end. This depth of integrity and alignment is what new public health truly needs from entrepreneurs.