Is India's healthcare industry ready for the 'longevity' disruption? Deepak Saini weighs in

This, along with a lower population replacement level, is expected to shift the average age of the population upwards. This change, which involves a greater role or say of older people in wealth creation and decision making, shifts the market dynamics from catering to younger people to older individuals who can possibly afford more niche solutions to their needs. Interestingly, while the overall numbers increase, the population in the rural settings will also increase at the same pace, and 60 percent of the elderly population will be in rural areas in 2025, requiring resource reallocation and a change in health care narrative from the young ones to senior care.

The transition is also fuelling the health care sector, and an evident shift from traditional ‘sick care’ to proactive wellness is seen, with startups and established players investing heavily in early interventions, cellular repair, and AI (artificial intelligence)-driven health solutions. This ecosystem is fuelled by everyone alive and has money to burn, attracting venture funding and fostering deep-technological innovations in personalised, preventive, and participatory treatments. 

As longevity becomes a central economic driver, industries from health care to financial services are reimagining products for an ageing population, creating new opportunities and fundamentally altering the landscape of ageing, work and retirement.

However, this landscape is coloured differently for India, where our demographic dividend of the younger nation is rapidly changing, and we stare at 3x Indians above 60 by 2050. This shift and uneven distribution of resources, which have always plagued us, will complicate care needs, urging innovations in insurance, preventive health and retirement planning. This increase in life expectancy from the 70s to the 90s, along with a lower population replacement level, will inevitably create the world’s largest pool of aged population, with fewer and fewer caregivers. Are we as a nation ready for it?

Also read: Are you ready for the "longevity economy"?

The emergence of the longevity industry has been described in several ways; it has received responses that range from fascination, scepticism, elitism, vanity, futuristic, too early, capitalistic, to necessary, and being the next big thing for humanity. Irrespective, the inevitability of ageing makes everyone think and worry about both mortality and ageism. While most find it prudent to talk about lifespan or long life, discussions about health span have crept onto the main stage.

How does one maintain good health, and when does one not worry about falling sick? On an average, an American spends $6,000 on wellness today, almost 50 times higher than an Indian ($110). This disparity calls for addressing the differences in health care needs between various populations.

While a country like India must address the medical needs arising from recurrent infections and poor nutrition, the health care need of the Western world revolves more around addressing chronic metabolic and lifestyle disorders.

Disruption in the longevity industry must meet these disparities to truly have a global impact, which is not possible given that the underlying causes, though known, are not entirely manageable. While tackling exaggerated inflammation might improve quality of life in chronic diseases, an ill-timed suppression of inflammation will increase susceptibility to infection, beckoning a simple question: When and how much to fix, as the implication of over- and under-fixing will reduce quality of life.

So, what is being touted as the magic solution to improve quality of life? Large academic institutions, research centres, and philanthropy-backed programmes and companies alike are all looking for that elixir of youth, which will magically turn back the clock. Right from metabolic modulators, Metformin and GLP inhibitors; immunosuppressants like Rapamycin; antioxidants like N-acetyl L-cysteine, resveratrol, berberine, and circadian rhythm modulators like melatonin, all are being touted as the next big things in the longevity industry, with none having any clear scientific backing to say that they can be used for the masses and will work for everyone. And yet time and again, the debate is won by age-old parameters championed by the blue zones of the world, which include plant-based diets, good sleep and social interactions. The magic pill is still missing, but the hope is not.

Interestingly, despite these limited scientific understandings, the longevity and wellness industry was pegged at $6.3 trillion in 2023, and one-third of that was for North America alone. The share of the Indian market is currently very low, ranging between $200 billion and $600 billion, depending on the aspects included in the report. The industry is also mixed and includes diagnostic and wellness clinics, supplement markets, nutrition and diet, wearables and monitors, and even traditional hospitals have wellness clinics now. Despite this vast opportunity, one key narrative that is always at the heart of India is about democratic access and affordability of the new age health care system by rural India, where the majority of our population resides. The impact of longevity will not be visible until we account for their requirements, as this population is vulnerable and does not have adequate access to modern medicine.

This becomes even more necessary as the current medical system is reactive, mainly curative in India, and it does not cater to preventive care because of broad generalised testing and its associated costs. A proactive health care system requires conscious, proactive decision-making, which includes aspects of an individual’s personal history, habits, lifestyle, disease predisposition and ongoing health care issues, which can only be deployed if the individual’s primary necessities, that is, food, shelter and security, have been met.

This fundamental aspect will have the maximum influence on the longevity industry, given that longevity can only be discussed after survival issues have been addressed.

While medical and technological innovations with AI interfaces have simplified the understanding of the needs of the masses, a true health concierge will only emerge once we have recorded the complexities and diversity of health parameters, lifestyle, food habits and culture, which is an inherent challenge for a country like India.

‘Ayushman Bhava’, the age-old saying, has a deep meaning, but, of course, it does not say how. The ‘how’ is what modern science and technology have to figure out, without losing the personal differences. The era of personalised medicine is truly dawning upon us and the longevity wagon is leading it from the front. With proactive Medicine 3.0 approaches and with agentic AI, we, as a country, where frugal innovation and holistic healing are championed, will be able to establish a longevity framework that can be globally emulated. With the right intent and investment, India has the potential to lead the world into the era of Medicine 4.0.