Can India's digital public infrastructure in health (ABDM, eSanjeevani) be a model for the BIMSTEC region? Critically analyse.

At the First BIMSTEC Health Ministers' Meeting in Colombo, India offered its UHC model to other members. That model is built on ABDM, eSanjeevani and AB PM-JAY. The regional BIMSTEC Digital Health Framework, however, is still described only as a "possible" framework [1]. India's health DPI is a credible template, but other members can only adopt it in part, and only after adapting it.

Why India's health DPI can be a model

• Proven scale: eSanjeevani has delivered over 50 crore teleconsultations, and over 1.85 lakh Ayushman Arogya Mandirs are in place [1].
• Interoperable by design: eSanjeevani is integrated with ABDM, so each consultation links to the citizen's digital health records [2].
• Fits regional needs: the proposed framework covers telemedicine, interoperable EHRs and AI in diagnostics [1]. This matches the 6th Summit's pilot study on DPI needs in the region [3].
• Proof on the ground: India's 50 Health ATMs for post-Cyclone Ditwah Sri Lanka show that point-of-care telemedicine can be exported [1].
• Strategic dividend: health diplomacy adds soft power to Neighbourhood First and Act East, alongside India's lead of the Security pillar [3].

Limitations and concerns

• Data-integrity gaps at home: CAG Report No. 11 of 2023 found that only 73% of target households were registered. It also found deceased patients shown as treated and 78,396 overlapping hospitalisations [4].
• No common standards: EHRs that work across borders need shared data standards and data-sharing agreements. The meeting announced neither [1].
• Consensus decision-making: any one hesitant member can stall rules on cross-border data [3].
• Weak delivery record: the MEA itself still aims only at the "early implementation" of BIMSTEC plans of action [3].
• Uneven readiness: connectivity, digital literacy and data-protection laws differ across the seven members.

Way forward

• Strengthen fraud and validation checks in ABDM and PM-JAY before exporting them [4].
• Offer open, modular components that each country can adapt to its own laws.
• Write a data-sharing protocol and a yearly scorecard into the Revised Plan of Action on Public Health (2026–2030) [1].
• Pilot the model through Health ATMs and telemedicine links in Sri Lanka, then scale up [1].

India's health DPI offers the scale, low cost and interoperability that BIMSTEC needs, but it is a template, not a ready-made export. If India fixes its own data gaps and builds shared standards with its neighbours, it can turn the "possible" framework into a working regional public good that advances UHC and SDG 3 for 1.7 billion people [3].