India has the fastest growing population, and an ambitious growth aspiration, but it has always had a disproportionately small health budget.
The world's highest number of women dying in childbirth; the world's highest deaths of children under the age of five; a health system that ranks 112 among 190 countries; one doctor for 1,700 people; 21% of the world's burden of disease, worsened by poor basic health and sanitation.
In a rare public criticism of Prime Minister Narendra Modi's policies, India's main program to fight child malnutrition has been hit by budget cuts that make it difficult to pay wages of millions of health workers, a cabinet minister said.
Modi's government in February slashed social sector budgets to boost infrastructure spending in a bid to fasten the pace of economic recovery. States were asked to fill the gap from the larger share of federal taxes they receive from New Delhi.
Maneka Gandhi, the women and child welfare minister who oversees a scheme to feed more than 100 million poor people, said the current budget was only enough to pay salaries of her 2.7 million health workers until January.
She said the February budget cut, which saw her ministry's budget slashed by half to $1.6 billion, had hit her plans to strengthen the fight against malnutrition.
Gandhi said that even before the cuts the food program was in urgent need of modernization, with lax supervision of health workers using training programs not updated in the last four decades and the food on offer she described as "rubbish." She said about half the food was lost due to mismanagement.
An official at Gandhi's ministry, who did not wish to be named, said states had cited fiscal strains and conveyed they were not willing to fund salaries. Gandhi, however, said she was hopeful the program will revive.