As Delhi gears up for the Assembly elections on February 5, 2025, the city’s healthcare system stands at a crossroads. The release of the People’s Health Manifesto by Jan Swasthya Abhiyan (JSA) Delhi is a stark reminder of the deep-rooted inequalities in access to healthcare in the state. This manifesto has been developed with the help of partners and through extensive consultations with health experts, grassroots organizations, trade unions, and community groups. It lays out the urgent need for political parties to take healthcare seriously in their election agendas.
Delhi is one of India’s wealthiest states, boasting the highest per capita Net State Domestic Product and a substantial tax base. Yet, for the city’s working-class population, particularly those in slums, resettlement colonies, and JJ clusters, even basic healthcare remains a distant dream. While the city is home to cutting-edge super-specialty hospitals in both public and private sectors, these facilities remain inaccessible to those who need them the most.
The crisis is further exacerbated by chronic under-investment in healthcare. Delhi currently spends only 0.8% of its GDP on health—a figure that falls far short of the recommended 2.5% in the short term, with an eventual goal of 3.5%. The burden of out-of-pocket expenditure forces people to make impossible choices between healthcare and other basic necessities, pushing them further into poverty.
The dominance of private healthcare in Delhi has only widened these gaps. With unchecked profiteering and rising costs, healthcare is increasingly being treated as a commodity rather than a public good. The manifesto calls for the enactment of a Delhi Health Act, aimed at regulating private sector costs and enforcing the Charter of Patients’ Rights. Such measures are critical in curbing exploitative practices and ensuring fair treatment for all citizens.
Social determinants of health: an unacknowledged crisis
Health inequities are deeply rooted in broader social determinants. Poverty, caste, gender, and religion continue to dictate access to healthcare. Queer and transgender individuals face additional discrimination, while marginalized communities struggle with deteriorating living conditions, pollution, and the rising costs of essential services.
While Delhi’s wealthy have access to the best healthcare, almost half the city’s population struggles for the basics. Their suffering is made worse by terrible living conditions in slums and low-income habitations.
Delhi’s environmental crisis adds another layer of complexity. From toxic air pollution to extreme heat waves, the city’s deteriorating environment has direct and devastating effects on public health. The manifesto calls for immediate interventions, including halting projects like the proposed Waste-to-Energy plant in Bawana, which poses potential environmental hazards.
The way forward
JSA Delhi’s People’s Health Manifesto is a roadmap for a healthier, more equitable Delhi. Some of the key proposals include:
- Increased public health investment: immediate allocation of 2.5% of GDP to health, scaling up to 3.5% over time.
- Expansion of primary health care infrastructure: building 4,000 mohalla (community) clinics or urban sub-centers—ten times the current number—to ensure accessible healthcare.
- Regulation of the private sector: enacting a Delhi Health Act to curb exploitative pricing and ensure accountability.
- Addressing social and environmental determinants: improved sanitation, access to clean water, better nutrition programs, and urgent action on climate-related health risks.
- Ensuring equitable access to healthcare: dedicated initiatives for women, refugees, migrant workers, and individuals with disabilities.
JSA Delhi’s message is clear: the upcoming elections must not be another missed opportunity. Health must be treated as a fundamental right, not a privilege reserved for a select few. The city’s leaders must commit to systemic reforms that prioritize people over profits. Delhi’s voters must demand a healthcare system that is accessible, equitable, and designed to serve all its citizens—not just those who can afford it.
People’s Health Dispatch is a fortnightly bulletin published by the People’s Health Movement and Peoples Dispatch. For more articles and to subscribe to People’s Health Dispatch, click here.
Jyotsna Singh and Richa Chintan are Co-conveners of Jan Swasthya Abhiyan – Delhi.
