"I think the key challenge is the tension between the prevailing approach of allowing two systems to operate in parallel (i.e., the public and private), with minimal regulation of either, with the need for a population-based health care system which integrates all providers within a common framework of accountability and quality. Related challenges include the growing reliance on an insurance model which pays for services rather than a per capita model which values health outcomes, the lack of trust between private and public sectors, and the need to aggressively address the single largest contributor to out of pocket costs, which is the inappropriate use of diagnostic interventions and medicines," says Vikram Patel, Pershing Square Professor of Global Health, Harvard Medical School; Professor, Harvard TH Chan School of Public Health; Co-founder, Sangath

"Our research suggests that India is lacking a lateral health systems approach to provide all levels of care from preventive medicine through tertiary and specialized care. To fully cover the residents of India, the fragmentation between vertical programs will need to be addressed. The other key is finding the right balance between centralized national control of healthcare and decentralized state control. Finding a way to customize and localize care state to state, where there are varying health needs, is critical to serving the population in need," says Noah Carton-Rossen, MPH candidate in health policy, Harvard T.H. Chan School of Public Health