Healthcare India 2035: How the World's Most Complex Health Market Will Become Its Most Innovative

Ten years ago, predicting that India would operate the world's largest digital payments infrastructure — with 16 billion monthly UPI transactions by 2025 — would have seemed implausible to anyone not paying close attention to the architecture being built quietly at the National Payments Corporation of India. The lesson of UPI is that India's digital infrastructure revolutions arrive faster than their critics predict and more durably than their boosters hope. Healthcare is next, and the infrastructure being built today — the Ayushman Bharat Digital Mission, the Genome India Project, the Digital Health Incentive Scheme — will make 2035 Indian healthcare as unrecognisable from 2025 as India's payment landscape is today from 2015.

This is not optimism for its own sake. The structural drivers of transformation are specific, documented, and already in motion. As leadership advisors to some of India's most consequential healthcare organisations, we believe that the strategic decisions being made in the next three to five years will determine who leads and who follows in the next decade's healthcare economy.

The Ayushman Bharat Digital Mission: Building the Stack

The Ayushman Bharat Digital Mission (ABDM), launched in 2021 and scaling rapidly, is building what may become the world's most ambitious national health data architecture. The core components — the Ayushman Bharat Health Account (ABHA ID), the Health Facility Registry, the Healthcare Professionals Registry, and the Health Records exchange protocols — create the plumbing for a unified, consent-based national health record system.

By the end of 2024, over 630 million ABHA IDs had been created, and more than 340,000 health facilities had enrolled in the Health Facility Registry. The ambition is a healthcare system where a patient's entire medical history — from a PHC in Bihar to a super-specialty hospital in Chennai — is portable, accessible with consent, and usable for both care delivery and population health management.

By 2035, if ABDM reaches its potential, India will have the world's largest linked health dataset. For healthcare leaders, the ABDM is not an IT initiative. It is the foundation of a fundamentally different care delivery model — one where care is coordinated around the patient's longitudinal record, not organised around institutional silos.

The Genomics Revolution: Personalised Medicine at Scale

The Genome India Project, launched by the Department of Biotechnology in 2020, aims to sequence 10,000 Indian genomes — eventually scaling to 100,000 — to build a reference genome database that captures India's extraordinary genetic diversity. India's population carries distinct genetic variants not well-represented in Western genomic databases, meaning that polygenic risk scores and pharmacogenomic predictions derived from Western data perform poorly in Indian patients.

Building an Indian-specific genomic reference will enable pharmacogenomics — matching drug choice and dosage to individual genetic profiles — reducing adverse drug reactions and improving treatment efficacy. Predisposition screening for diseases with high Indian prevalence — coronary artery disease, Type 2 diabetes, thalassemia — will enable preventive intervention decades before clinical manifestation.

Companies like MedGenome (headquartered in Bengaluru), Strand Life Sciences (part of Manipal Group's diagnostics ecosystem), and 4baseCare in Bengaluru are building the clinical genomics infrastructure. The National Institute of Biomedical Genomics (NIBMG) in Kalyani, West Bengal, is building the public sector genomics research infrastructure.

"In 2035, a diagnosis without genomic context will feel as incomplete as a diagnosis without a blood test feels today. The clinical and commercial implications of this shift are enormous."

Telemedicine at Scale: Redefining Access

eSanjeevani, the government's national telemedicine platform, crossed 300 million consultations by early 2025 — making it arguably the world's largest telemedicine implementation by volume. Built by C-DAC (Centre for Development of Advanced Computing) and operated through a network of health and wellness centres, eSanjeevani has demonstrated that telemedicine can function as a genuine access lever for primary healthcare in rural India.

The Telemedicine Practice Guidelines issued by the Board of Governors in supersession of MCI in 2020 established the regulatory framework for video, audio, and text consultations. By 2035, telemedicine in India will likely be a ₹35,000–₹40,000 crore market, with a mix of government-operated platforms (eSanjeevani), hospital-affiliated platforms (Apollo 247, Practo, mfine), and insurance-embedded services.

Medical Devices Manufacturing: The Coming Decade

India's medical devices sector today is largely import-dependent — approximately 80% of devices used in India are imported. The government's PLI scheme, the Medical Devices Parks, and the National Medical Devices Policy 2023 are collectively designed to change this. The target: a domestic medical devices industry of $50 billion by 2030.

Skanray Technologies in Bengaluru builds imaging equipment for export across Africa and Southeast Asia. Trivitron Healthcare manufactures a full range of diagnostic instruments and has built one of India's largest medical device distribution networks. Poly Medicure in Faridabad is a significant exporter of consumables to regulated Western markets. By 2035, India's ambition — to be for medical devices in emerging markets what it has been for pharmaceuticals globally — is achievable if the investment in quality systems, design capability, and regulatory expertise continues.

Value-Based Care and the Integration of AYUSH

The framework of value-based care — where providers are reimbursed for outcomes rather than procedures — is gaining traction in India, particularly through the National Quality Assurance Standards (NQAS) for public health facilities and the Ayushman Bharat Health and Wellness Centres model. By 2035, India will likely operate bundled payment models for selected high-burden conditions.

Alongside this, the integration of AYUSH (Ayurveda, Yoga, Unani, Siddha, Homeopathy) with evidence-based modern medicine is an area of genuine policy priority. The AYUSH sector is a ₹1.8 lakh crore market. The Ministry of AYUSH and the All India Institute of Ayurveda are investing in rigorous clinical research to build the evidence base for integrative medicine protocols.

What This Means for Leaders

The 2035 healthcare landscape will be defined by four structural shifts: a digital health stack that makes patient data portable and actionable, a genomics layer that enables personalisation, a telemedicine infrastructure that reaches every geography, and a devices manufacturing base that reduces India's import dependency.

At Gladwin International, we believe that the defining leadership competency for Indian healthcare in the next decade is systems thinking — the ability to see how digital infrastructure, clinical care, public health, and commercial viability fit together into a coherent, sustainable model. That combination is rare. The organisations that find it, develop it, and retain it will be the ones that define India's healthcare future.