Viksit Bharat 2047 envisions India as a $30-trillion economy with per capita income of $18,000–21,000, implying developed-nation status. Achieving this would require sustained nominal gross domestic product (GDP) growth of about 10% annually through structural transformation, higher productivity, and major investments in human capital, infrastructure, and innovation. Let us set aside the fact that India has never achieved such a high growth rate for more than a year at a time. Even with a $21,000 per capita GDP, will India be considered a developed country?
A developed country is one whose wealth rests primarily on human capital rather than natural resources. Its people are educated, healthy, and productive, forming the foundation for innovation and sustained economic growth. Such nations have diversified economies built on ideas, research, and services, supported by strong institutions and equitable access to health care, education, and opportunity. Governance is stable, and prosperity is widely shared, allowing creativity and productivity to reinforce each other. In essence, development means shifting from extracting value from the land to generating value from human potential — the transformation of natural wealth into enduring human capability.
Economic growth without parallel investment in health is possible, but is almost always temporary and uneven. Several countries — particularly resource-rich or trade-driven economies — have achieved rising GDP per capita even as public health systems remained underfunded. In such cases, growth is propelled by sectors like oil, mining, or remittances rather than by broad human-capital development. Improvements in early survival may still occur through better sanitation, education, or nutrition, giving the illusion of health progress without major health spending. Yet, once infectious diseases recede and populations age, the limits of this model become clear. Chronic illnesses, urban pollution, and unequal access to care begin to erode both productivity and social stability.
Empirical studies from parts of Central Asia, sub-Saharan Africa, and Latin America show that countries can grow for years while health indicators stagnate. But this “decoupling” of income and well-being tends to reverse: Poor health eventually constrains labor productivity, increases dependency ratios, and raises health care costs, dampening long-term growth. Nations that fail to invest in maternal health, preventive care, and disease surveillance often find their early economic gains offset by rising non-communicable disease burdens and widening inequality.
Historically, sustainable development has depended not just on higher incomes but on deliberate social investment — public health, education, and environmental protection. Where such investment is neglected, growth rests on narrow foundations. In contrast, countries that integrated health into development — such as South Korea, Sri Lanka, or Costa Rica — converted economic gains into longevity, workforce resilience, and social cohesion.
The lesson is clear: Economic growth can occur without health investment, but only for a while. Over time, neglecting the health of the population transforms growth from an engine of progress into a source of fragility, amplifying the very inequities that development was meant to overcome.
Life expectancy at birth is one measure of health — imperfect yet stable. India’s life-expectancy goals are ambitious but unevenly grounded in current trends. Although there is no stated national target under Viksit Bharat vision documents, several states have articulated concrete targets. Gujarat aims for an average lifespan of 84 years alongside a very low infant mortality rate; Andhra Pradesh targets 85 years and a maternal mortality ratio below 25 by 2029; Uttar Pradesh tracks insurance coverage milestones as part of its health agenda but without quantitative targets on life expectancy. Nationally, life expectancy has been rising by about 0.4 years annually. In the most optimistic scenario, a level of 81 years by 2047 is realistic, but that requires the current rate of progress to continue.
But that is unlikely. Communicable-disease mortality has already fallen sharply, but non-communicable diseases now account for roughly 65% of all deaths (ICMR-GBD 2023). Without decisive action on obesity, diabetes, cardiovascular disorders, air pollution, and mental-health care, India’s steady climb could flatten by the 2030s — mirroring the plateau seen in wealthier nations. Between 2005 and 2015, life expectancy rose by four to five years, driven by investments in maternal and child health, immunization, and infection control; Since 2015, the pace has slowed to about three years per decade.
Even in a moderately optimistic scenario, India’s life expectancy will reach only 78 years by 2047, well short of the stated goal of 84 years. Such deceleration is common once countries undergo a demographic transition: Mortality shifts from infectious to chronic causes, and gains become harder to achieve. Mexico offers a cautionary parallel — its life expectancy has stalled around 75 years, rising by barely 0.9 years per decade. Unless India sustains health investment and prevention at scale, it risks following that same arc of early success followed by stagnation.
India has, in recent years, stepped back from strong central investment in public health, leaving states to shoulder the burden. That approach is unsustainable. In competing to attract industry, states risk a race to the bottom — lowering environmental standards and eroding quality of life for all. The consequences are already visible in the poor air quality of Delhi and Mumbai, where the limits of State control are painfully evident.
Health and environmental quality are not rewards of prosperity; they are its foundations. The seriousness with which India aligns public-health spending and enforcement of environmental quality to its aspiration of becoming a developed nation will determine whether Viksit Bharat remains a vision — or becomes a reality.
Ramanan Laxminarayan is president, One Health Trust. The views expressed are personal
