Insulated at home, indispensable abroad: positioning India's global health strategy after the 2025 contraction in development assistance.

In 2025, development assistance for health fell by about 21% in a single year, driven largely by a 67% cut in United States financing. India sits in an unusual dual position: its core disease programmes, including tuberculosis treatment, are largely domestically financed and comparatively insulated, while much of the developing world depends on it for affordable medicines and vaccines. Falling donor procurement through the Global Fund, Gavi and other channels threatens demand for India-made commodities, while a heavy dependence on imported ingredients leaves the supply base fragile. This brief treats the shock as both a supply-security risk and a strategic opening, and sets out domestic, manufacturing and diplomatic actions to protect access and assume greater leadership.