India's Republic Day on January 26 in Delhi served as the backdrop for the launch of The Lancet Commission on a Citizen-Centred Health System in India. The commission describes progress over the past 20 years, including the National Rural Health Mission, ambitious national health policies, a new cadre of ASHA health workers and the Ayushman Bharat program of 2018. The goal is to achieve a Viksit Bharat, or developed India, by 2047, the centenary of independence. The Commission highlights that improvements in health outcomes, such as longer lives and reduced infant and maternal mortality, have not been accompanied by comparable advances in care delivery. Fragmented governance, weak accountability and a system organized around facilities rather than patients remain problems. The Commission proposes to separate the roles of buyer and provider so that public finances follow the patient, and recommends gradual reforms at the district level. The report was publicly released on January 21, 2026 in New Delhi.