The UDF Health Commission would like to thank the UDF Chairman Mr VD Satheesan and other UDF leaders for prioritizing health and for establishing a commission to investigate the health system of Kerala. The mandate of the Commission was to study the serious challenges of the health system in Kerala, to identify the barriers to health and well-being of the people, and to suggest scientific and practical solutions.

Kerala is in the ‘second wave’ of epidemiological transition where disease burden is rapidly shifting to noncommunicable diseases characterized by a high burden of chronic and metabolic diseases among its ageing populace. The current, recurring, and emerging public health challenges will be the foundation of a new Kerala Health Policy, the UDF envisions. Appointment of this Health Commission on 30th June 2025 was a clear demonstration of UDF’s commitment towards its vision ‘Health Mission 2050’.

From July 2025 to January 2026, the commission has done extensive consultations with over 600 stakeholders starting from common people to international experts which included patients, patient groups, doctors, nurses, public health experts, health professionals, community health workers, community volunteers, media personnel, administrators, bureaucrats, health finance experts, economists, researchers, academicians, elected representatives, vulnerable and special needs populations, hospital managements, entrepreneurs, and innovators. The methodology included review of literature, one-on-one interactions, group meetings, special sittings at selected places, field visits, video conferences, teleconferences, web-based interactions, and a health conclave which was attended by over 300 participants. The data was systematically analyzed using biomedical and socioecological models. For the analysis, we used WHO’s Health System pillars approach, WHO’s health indicators, and SDG-related health indicators as fundamental frameworks.

Our analysis and recommendations are guided by explicit theories, values, and principles. We acknowledge health as a human right, and health equity as the guiding principle. In this process, we have been attempting to lay a solid foundation for a bipartisan health policy which should have data- and evidence-informed vision for the health and well-being of all people in Kerala. We also recommend eliminating the growing trend of profiteering from health events, and essential care and treatment needs. Our recommendations are also rooted in the concept of ‘One Health’ which include monitoring the socio-epidemiological consequences of growing human-animal conflict. There should also be focus on ‘health in all policies’ and in mitigating the health implications of pollution and environmental crises. In addition, we recommend enhanced medical and public health research.

Kerala State’s market-shaping ability should be fully utilised to control the prices of drugs, diagnostics, and assistive technologies. Innovations in treatment, diagnostics, and assistive technology, including the use of AI in prevention, care, support, and treatment must be encouraged. A real-time, disaggregated data-informed epidemiological surveillance including that of veterinary sector, should be in place to address the current and emerging health challenges. There should be emphasis on monitoring and mitigating the health impact of recurring disasters in the state. We also acknowledge the need for strengthening the ‘Kerala Centre for Disease Control and Prevention’ and revising its mandate. While the state’s investment in public health remains less than 4% of the state budget, which is a historic low in Kerala’s public health history, unregulated privatization of healthcare is growing in Kerala. The private sector investments, innovations, and services have a major stake in the success story of the state. However, the current neoliberal health policies squander the opportunities to provide strong universal primary care, promote respectful maternity care, lower the burden of NCDs, and to prevent poverty resulting from catastrophic health expenditure. To create a true ‘Kerala Model in Health’, there is a need for reforms that would address all the major issues mentioned above.

I, on behalf of the members (Dr SS Lal, Dr Sreejith N Kumar, Dr PN Ajitha, Dr Rajan Joseph Manjooran, Dr OT Muhammed Basheer), advisors and the secretariat of UDF Health Commission, would like to thank all the stakeholders who spent time with us in the discussions and deliberations, and generously contributed to this report.

Thank you.

Dr SS Lal

Chairman, UDF Health Commission