A Veloxx Media Interview Feature
Featuring
Ajay Chagti, IAS
2010-batch Indian Administrative Service
Former Secretary (Health & Medical Education), Chandigarh
At a time when India’s healthcare system is being reshaped by the dual challenge of a rising non-communicable disease burden and the growing need for technology-enabled, patient-centric care, public institutions are being called upon to think beyond conventional service delivery. The agenda is no longer limited to disease control alone; it now spans cancer prevention and affordability, digital health records, health data privacy, AI in healthcare, pharmaceutical innovation, and the growing policy urgency around geriatric care. This broader transition demands administrative leadership that can connect public health priorities with emerging technologies, system design, and long-term institutional execution.
This conversation features Ajay Chagti, IAS, a 2010-batch officer of the AGMUT cadre, with an academic background in engineering and management from Punjab University, who has served in Chandigarh’s health administration and public institutional leadership across several key departments across diverse regions. In this interview, he reflects on how India is addressing lifestyle-driven NCDs, strengthening cancer prevention, advancing the Ayushman Bharat Digital Mission (ABDM), approaching privacy-by-design in digital health in the era of the DPDP Act, exploring the real-world use of AI in healthcare, and thinking through the next phase of pharmaceutical capability and elderly care.
The discussion offers a policy-grounded view of how India’s healthcare ecosystem is evolving across prevention, affordability, digitisation, innovation, and access. It also underlines a central theme increasingly relevant to the sector: that the future of healthcare will depend not only on medical infrastructure, but on how effectively governance, data systems, technology adoption, and public health strategy are aligned on the ground.
All responses below are reproduced exactly as shared, preserving the clarity, intent, and domain depth of the interviewee’s views.
Q1- Communicable diseases are declining in India due to enhanced public health initiatives. However, the burden of NCDs and the resultant deaths are a cause of concern. How is this being addressed?
Ans- Lifestyle changes are primarily responsible for this. The strategy under National Programme for Prevention and Control of Non Communicable Diseases (NP-NCD) focuses on health promotion and awareness activities, population based screening for common NCDs for all population above 30 years of age, timely management of Hypertension, Diabetes, Oral, Breast and Cervical Cancers, COPD, CKD, STEMI, Stroke and NAFLD at District / CHC level, Data updation and monitoring through National NCD Portal, collaboration with other sectors through National Multisectoral Action Plan and linkages with other initiatives such as Eat Right Movement, Fit India Movement.
Q2 – Cancer has been called as Emperor of maladies. Cost of treatment remains high. What are the current trends? What steps are being taken to address the issues?
Ans- As per National Cancer Registry Programme, one in nine Indians may develop cancer. About 25 lakh persons are having cancer. Cancer incidence is rising by 12.8 per cent annually. Among males, cancers of lung, mouth, oesophagus and stomach are prominent while breast cancer is the most common cancer in females followed by cervical cancer. Persistent infection with high-risk Human Papillomavirus (HPV) types, particularly types 16 and 18 has been established as the primary cause of cervical cancer.
Early detection and prevention is the cornerstone of the policy for fighting cancer. The nationwide Human Papillomavirus (HPV) Vaccination Campaign for 14-year-old girls is a defining moment aiming to prevent cervical cancer by protecting girls before potential exposure to HPV infection.
Advanced cancer treatment facilities are available in tertiary hospitals. AB-PMJAY provides ₹5 lakh annual health cover per family for various health conditions including cancer treatment, surgery, chemotherapy, and radiation. To reduce cost of cancer treatment, custom duties have been waived off on17 cancer drugs in the latest budget.
The Indian Institute of Technology (Madras) has launched the Bharat Cancer Genome Atlas, a database of Indian cancer genomes, and the Bharat Cancer Genome Grid to facilitate mapping, understanding treatment and monitoring.
Q3 – In which areas is technology helping improve healthcare ?
Ans – Technology has facilitated disease surveillance, accessible healthcare through telehealth, mHealth through smart phones and wearable devices, online health records through ABDM ecosystem, healthcare management systems etc.
Q4 – Ayushman Bharat Digital Mission was launched 5 years ago. What are the achievements? How are patient data privacy concerns being addressed especially with the enactment of Digital Personal Data Protection (DPDP) Act?
Ans – ABDM has successfully led to creation of a unified digital health ecosystem with 86.38 crore ABHA IDs, 89.61 cr electronic health records. 4.7 lakh health facilities and 8.23 lakh health professionals have been onboarded. This has created a huge database for transformation of India’s healthcare system.
As regards privacy concerns, Privacy by design was the guiding principle even before the DPDP Act was enacted. There is no centralised data repository under ABDM. The provision regarding explicit, informed, and revocable consent for data exchange between patients and healthcare providers is in alignment with DPDP Act.
Q5 – AI in Healthcare should be measured by its impact on lives. What is the roadmap? How is AI being used in Indian Healthcare sector currently?
Ans – The Strategy for Artificial Intelligence in Healthcare for India aims at safe, ethical, evidence-based, and inclusive adoption of Artificial Intelligence across India’s healthcare facilities.
AI is being adopted in many areas. This includes clinical decision support systems (CDSS) in the e-Sanjeevani teleconsultation. About 28.2 crore consultations have used AI-generated differential diagnosis recommendations since April 2023.
TB case detection has been augmented with AI-enabled handheld X-ray machines and Computer-Aided Detection tools for tuberculosis (CA-TB).
The AI enabled Media Disease Surveillance System helps monitor various trends / patterns in disease in 13 languages. Real-time alerts enable proactive action.
The Indian Council of Medical Research has started genomic surveillance with the help of AI for predicting potential zoonotic outbreaks even before transmission from animals to humans occurs.
The MadhuNetrAI solution enables screening for diabetic retinopathy by nonspecialist health workers by examining retinal fundus images.
Fraud detection in the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana has been aided by AI.
The impact of AI will be further enhanced in remote areas (without sufficient internet bandwidth) with Small Language Models and AI enabled voice based interactions.
Q6 – How can other emerging technologies revolutionise healthcare
Ans – Some practical applications can be explored/ are being used already e.g.
- Robotics for (i) precision and control in surgeries (ii) automating repetitive tasks (iii) providing support to patients under medical watch in hospitals or post discharge;
- Blockchain for (i) data security and control in the decentralized ecosystem of Ayushman Bharat Digital Mission (ii) establishing provenance of medical drugs etc. through smart supply chain (iii) verification of records of qualified healthcare personnel facilitated by blockchain enabled registries of Medical Councils, Medical colleges etc.
- Internet of Medical Things for exchange of patient data with other IoT devices thereby enhancing remote monitoring and timely medical intervention (ii)tracking of hospital and other assets (iii) ensuring exact dosage of medication and reminders / alerts etc.
- Nanotechnology for manipulating materials at the atomic or molecular level for diagnostics, nano sensor based disease detection, targeted drug delivery minimising damage to healthy tissue, regenerative medicine / tissue engineering etc.
Q7 – Any observations on the constraints and policy intent for transforming pharmaceutical sector from generics focussed to advanced knowledge / manufacturing hub.
Ans – Huge costs and long gestation periods are the constraints in innovation in this field. Opportunity for facilitating advanced treatment and significant value addition lies in becoming a global hub for biologics (made from living organisms or cells rather than simple chemical synthesis). Harnessing biologics involves growth and extraction of living systems. Therefore, technically this is far more complex process than making chemical drugs.
The recent Budget announced a five-year Rs 10,000 crore initiative “Strategy for Healthcare Advancement through Knowledge, Technology, and Innovation”. It aims at making our country a global hub for biologics & biosimilars and also capturing 5% of the global biopharmaceutical market. The roadmap refers to enhancing domestic manufacturing, upgrading NIPERs, and strengthening clinical trial infrastructure.
Execution at ground level and entrepreneurship will determine how fast we can leapfrog in this area.
Q8 – What steps can be taken to improve geriatric care ?
Ans – Government has already addressed the legal issues with “The Maintenance and Welfare of Parents and Senior Citizens Act, 2007”. Section 144 of the Bharatiya Nagarik Suraksha Sanhita (BNSS), 2023 allows dependents to seek maintenance from persons with sufficient means who neglect or refuse to maintain them.
Many slervices are currently provided under National Programme for the Health Care of Elderly (NPHCE). Vulnerable groups are supported under various welfare programs.
One can further streamline these initiatives with proper mapping of individual health conditions, past history of ailments and treatments and consequent risk analysis. Senior care packages including medication and nutritional needs assessment can follow. This will require sufficient medical / para medical professionals.
Professional home care services are now partly covering infrastructure gaps;however standards need to be crystallized and regulatory oversight may be considered. Simultaneously there is need for sensitization of family / care givers about these issues.
ABOUT THE SERIES
This conversation is part of Veloxx Media’s Leadership Interview Series, featuring voices and insights from key figures in public institutions and industry bodies shaping India’s economic and institutional future.
