New Delhi

Union Health Minister J P Nadda on Monday expressed strong concern over the underutilisation of allocated health funds by states and asked them to focus on improving healthcare infrastructure.

Chairing a session at the 17th Civil Services Day celebrations here, Nadda said, “I will not allow this narrative to continue that there’s no money or capacity to spend it. Utilisation certificates are not even submitted for funds already given.”

He recounted a recent visit to a state where allocated funds remained unspent for three years due to repeated tendering and delay in equipment procurement.

“Models have changed, new versions have come, but the tender process hasn't even begun,” he said.

Calling implementation the crux of the problem, Nadda said, “We can aim for the world’s largest health coverage program...we will not let it go down the drain.”

He stressed that accountability and coordination across all administrative levels are essential, especially when out-of-pocket expenditure for health has reduced from 62 per cent to 39 per cent — calling it a clear sign of the benefit to common citizens.

Highlighting the need for administrative reform within the health sector, Nadda said that many officials, including state health directors and chief medical officers, lack proper training and are hesitant to make decisions.

“They are administratively incapacitated. We must support them through capacity building and handholding,” he said.

He pointed out that many district-level administrators are unaware of the Program Implementation Plan (PIP) under the National Health Mission (NHM), which is central to planning and executing healthcare initiatives.

“How can they plan if they don’t even know the year’s implementation plan?” Nadda questioned, and urged IAS officers to take ownership of the PIP and involve district officials in planning before forwarding it to Delhi.

Praising India's COVID-19 vaccination campaign, the health minister said, “We were able to deliver over 220 crore doses including boosters...it’s proof of how robust our health system is.” He also emphasized the need to invest in grassroots workers.

He called for increased reliance on and incentivisation of ASHA workers and for strengthening telemedicine services.

Nadda criticized the disconnect between government offerings and public awareness, noting that despite 157 medicines being offered free at Primary Health Centres, patients often report shortages.

He asked district magistrates and sub-divisional magistrates to conduct impact assessments to ensure the availability of diagnostics and medicines.

He also reiterated the government’s long-term vision for Ayushman Bharat, which includes the PM-JAY insurance scheme and Ayushman Arogya Mandirs. These, he said, stemmed from extensive consultation since 2015, unlike earlier fragmented health policies.

“This is India’s first holistic and inclusive health policy,” he said, noting its emphasis on geriatric care and early screening for non-communicable diseases.

“By the age of 30, everyone should be visiting Arogya Mandirs for screening hypertension, diabetes, oral and cervical cancer, and mental and dental health,” he said, underlining the shift from treatment to preventive healthcare.

India has already extended health coverage to 61 crore citizens under PM-JAY, Nadda said, adding that public health expenditure has increased from 29 per cent in 2014 to 48 pre cent today.

Dr V K Paul, NITI Aayog member, also spoke at the event, warning that antimicrobial resistance (AMR) may become the leading cause of death globally by 2050, surpassing cancer.

He announced that India’s second national action plan on AMR, involving 14 ministries, is ready for release.

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“We have a way forward that includes proper antibiotic usage and R&D. This is not just about India — it’s about global health,” Dr Paul said, urging cross-sector collaboration and calling on civil servants to “break the silos”.

Secretary of Health, Punya Salila Srivastava, highlighted the impact of Ayushman Bharat, noting an 11.7 per cent increase in rural health insurance coverage and major reductions in catastrophic health expenses, especially for women and senior citizens.