Startups are developing solutions to improve healthcare delivery in India, including tools for early disease detection and remote monitoring, which help frontline medical staff make more informed decisions. However, the main challenge lies in integrating these technologies into India's existing public health system and ensuring their accessibility.
At the TechSparks 2026 event, Dr. Gita Mandjunath, Founder and CEO of Niramai Health Analytix; Debraj Banerjee, Global Technology Investor and General Partner at Fundamentum Frontier Advisors; and Shekhar Sivasubramanian, Head of Wadhwani AI, discussed innovations in healthcare and the role of artificial intelligence, as well as the reasons why promising developments often fail to achieve widespread adoption.
According to the panel participants, startups face three interconnected challenges: the need for rigorous clinical validation, integration with existing public health infrastructure, and the requirement for patient capital to scale solutions across India's diverse healthcare ecosystem.
Shekhar Sivasubramanian, Head of Wadhwani AI, stated that 'there are no gaps in the system,' asserting that innovators should learn to build solutions considering real constraints rather than viewing them as obstacles. He emphasized that developers must account for realities such as inconsistent internet connectivity, incomplete data, and the necessity of operating in different languages and cultural contexts.
Gita Mandjunath noted that one of the primary barriers to technology adoption is the tendency to prioritize rapid product creation over its clinical validation. Although AI tools can be built in days using pre-existing datasets, a model that performs well in a lab does not guarantee reliable results when used in real medical practice.
She clarified: 'The question is not whether you create your model. The real problem is seeing if your algorithm works on real people.' Retrospective studies based on existing hospital data can be used for initial assessment, while prospective studies test the technology in a live clinical setting without allowing its predictions to influence treatment, and then compare the results with established clinical data.
Nevertheless, Mandjunath added that even these stages may be insufficient for public health implementation. A technology tested in a hospital must also be evaluated in the conditions where it is intended for use, including rural areas with limited diagnostic infrastructure. Before recommending a technology for wider application, the cost of implementation, deployment feasibility, and clinical effectiveness must be considered. She concluded that 'healthcare requires more patience,' and that founders need resilience and long-term commitment.
Beyond clinical validation, a significant challenge remains the incorporation of new technologies into existing government systems. Sivasubramanian from Wadhwani AI advised companies in public health to understand the systems used by both central and state authorities. His organization has teams working in health offices across 17 states, with groups of five to seven people in those offices.
This approach is necessary because technology implementation requires more than just developing a functional product. Teams must train users, understand local requirements, and adapt their solutions to existing workflows. He stressed that every application requires integration with primary healthcare infrastructure. Sivasubramanian noted that there are about 150,000 primary healthcare centers in India, and innovators must be prepared to operate at that scale. Without patience, persistence, and sufficient financial resources, a company can reach the halfway point, become discouraged, and abandon the project. He added that government officials implement these solutions, while innovators act as facilitators, and tech companies must work with them rather than assuming they can achieve change independently.
For medical technologies to reach underserved populations, their design must incorporate accessibility and acceptability. Gita Mandjunath cited Niramai's breast cancer screening technology as an example. The company uses thermal imaging and AI to assess breast cancer risk through a non-invasive screening process. The company's goal is to reduce screening costs to below 50 rupees at scale. This technology is also designed to eliminate barriers preventing women from undergoing screenings, including discomfort from procedures requiring physical contact or breast compression.
Mandjunath defined accessibility, acceptability, feasibility, and accuracy as key requirements for successful AI adoption in public health. Timeliness of results and clear accountability are also important. For investors, the task goes beyond determining technological functionality; they must assess whether the business can obtain regulatory approvals, meet financial requirements, and handle customer acquisition complexities.
Debraj Banerjee, General Partner at Fundamental Frontier Advisors, stated that high-tech companies require an ecosystem that supports the transition from product development to commercialization. He emphasized that 'there is no single formula for scaling medical innovations.' When evaluating AI-based products, he said that fundamental principles and their applicability to the product are considered. The product must be properly segmented, integrated into the relevant system, and localized. These factors help assess the probability of investment success.
Banerjee also noted that venture capital is only part of the entire ecosystem, and there needs to be development of a broader network of healthcare providers, regulators, investors, and commercial partners. The broader issue, in his view, is not simply creating better technology but building systems that allow it to reach users.
For Niramai, opportunities extend beyond India, as the company has screened around seven hundred thousand women and is working to expand access to its technology. Gita Mandjunath stated that the company's goal is to cover every woman, acknowledging that this will require sustained effort over many years. The company has also entered international markets. The same technology can be relevant in developed markets where healthcare systems seek ways to manage costs. Niramai has six centers in the US using its solution and has received FDA approval for co-use with existing screening methods. However, she added that expansion requires a different approach in each market, as regulatory requirements, reimbursement structures, and pricing models vary, and the solution cannot always be deployed identically everywhere. She concluded that Indian health innovators should not forgo international opportunities due to the need to create solutions for local needs.
