India's Digital Health Infrastructure Is Not Yet Sovereign

Time of India

16 hours ago

In a world increasingly defined by digital sovereignty, few sectors remain as exposed and as under-examined as healthcare.
Over the past decade, discussions about data localization have centered on payments, social media, and consumer platforms.
Despite its scale and sensitivity, healthcare has rarely been treated with the same urgency. That oversight is unlikely to endure.
The digital systems that underpin modern care, including AI diagnostics, electronic health records, and remote monitoring, have evolved beyond mere service tools into strategic national infrastructure. Yet even as these systems advance, the foundations beneath them continue to reflect dependencies that are neither obvious nor sustainable.
This dependency often emerges quietly. It appears in clinical models trained on foreign datasets, in health data stored on overseas servers, and in compute capacity concentrated in a few urban centers and operated by firms outside national oversight.
These are not minor operational choices. They are signs of structural imbalance. In a world where governance increasingly lives within infrastructure, such imbalances tend to widen over time.
One early indicator came when the United States restricted exports of high-end GPUs to China. Presented as a safeguard against general-purpose AI, the move also disrupted China's capacity to develop sovereign healthcare technology.
Without domestic compute capabilities, efforts to build clinical models grounded in national data become constrained, creating reliance on external intelligence shaped by foreign priorities and assumptions.
India, by contrast, has made significant progress. Aadhaar, UPI, DigiLocker, CoWIN, and the Ayushman Bharat Digital Mission form one of the most ambitious public digital infrastructures in the world.
These systems have enabled unprecedented access at scale. But building digital rails alone does not guarantee a sovereign destination. Without foundational control over compute infrastructure, data governance, and system resilience, healthcare remains locally administered yet externally contingent.
The challenge ahead is not only to expand existing infrastructure but to design systems inherently sovereign. Health data now sits at the intersection of ethics, economics, and strategy.
It influences hospital triage decisions, determines how insurers model risk, and guides how algorithms learn. At national scale, this data quietly accumulates into a form of strategic leverage. Countries unable to govern this data autonomously risk a subtle yet persistent erosion of strategic agency.
India's opportunity lies in constructing infrastructure aligned with long-term national priorities rather than shortterm efficiencies. Compute capacity should be distributed according to population density, not merely the flow of investment capital.
Clinical models must be developed using Indian datasets within governance frameworks that ensure interoperability without sacrificing autonomy. Institutional partnerships should emphasize durable alignment of interests over immediate vendor integration.
This transition is already underway. India's evolving data governance frameworks and the federated architecture of its health data systems point to a deeper intent to decentralize trust and build genuine internal resilience. But ambition without execution creates only the appearance of readiness.
What matters now is execution – measured not in press releases, but in hardware, architecture, and lasting institutional ownership.
The countries best prepared to protect public health in the coming decades will not necessarily be those with the largest budgets or the newest hospitals. They will be those that understand where strategic exposure truly lies: in compute, in code, and in control over the systems that connect them.
India still has time to build what others are scrambling to defend.
This article is written by Aakanxit Khullar, Vice President at a Global Consulting Firm.
(DISCLAIMER: The views expressed are solely of the author and ETHealthworld.com does not necessarily subscribe to it. ETHealthworld.com shall not be responsible for any damage caused to any person/organisation directly or indirectly)