About the project
The project focuses on the "democracy–healthcare paradox" by looking closely at one of India’s most marginalized communities, “Scheduled Tribes” (Adivasi), who face high levels of disease, maternal and child mortality, malnutrition, and limited access to health services.
The project is organized into three main parts. First, we examine how democracy and electoral politics impact healthcare policy. Second, we study how India’s flagship Universal Health Coverage initiative, the Ayushman Bharat Program (ABP), actually works on the ground in two different states, Jharkhand and Tamil Nadu, and whether it improves access to healthcare for Adivasi communities. Third, we compare India’s healthcare diplomacy in South Africa and Malawi with China’s approach.
HOPE addresses global challenges through interdisciplinary research on democracy, development, and health governance.
By examining Adivasi healthcare access and its governance implications, it advances the Sustainable Development Goals (SDGs), particularly in health equity, institutional integrity, and inclusive development. Through international collaborations, HOPE fosters knowledge-driven solutions that strengthen research partnerships and policy impact.
Goals
HOPE has five main goals. First, it seeks to understand how India's recent democratic backsliding and changing electoral politics affect health governance and policy priorities.
Second, it evaluates whether India's flagship Universal Health Coverage scheme, the Ayushman Bharat Program, improves access to healthcare for Adivasi families in states such as Jharkhand and Tamil Nadu.
Third, it investigates how India's rising power and development ambitions shape its health diplomacy and its leadership claims in the global South.
Fourth, HOPE aims to contribute to debates in India, Africa and beyond on the role of the private sector, democratic norms and South–South cooperation in health.
Finally, the project will publish research, engage the public and strengthen academic and policy partnerships to support more equitable and inclusive health systems.
Background
India is often celebrated as a resilient democracy and an emerging global power, yet millions still lack basic healthcare. Public health spending remains low, private providers dominate, and poor and rural populations bear the brunt of these gaps.
At the same time, India is increasingly seen as a key actor in global health, promoting low-cost innovations and development cooperation across the global South.
Methodologically, the project combines analysis of national policies and democratic institutions, in-depth study of Adivasi healthcare access and outcomes, and comparative work on India's health diplomacy in South Africa and Malawi, including how it compares to China's approach.
By addressing these interconnected questions, HOPE aims to provide a deeper understanding of how political systems shape development trajectories and inform policy choices in diverse contexts.
