It’s time for healthkeeper infrastructure: It’ll keep Gen Z in good shape as it takes over India’s workforce

India’s demographic dividend has long been hailed as our greatest asset: a young, dynamic population poised to fuel innovation, productivity and economic growth. But the picture is fast changing. Fertility rates are declining; in several Indian states, they have fallen below the replacement level of 2.1 children per woman. In other words, one man and one woman are no longer replacing themselves with two children. And with less than 25 years left to realize the country’s Viksit Bharat vision, we need to act now.

Recently, I met a 27-year-old entrepreneur who was quietly managing pre-diabetes and early signs of hypertension. He wore a fitness band, logged meals and calibrated his routine through device-led data. “I just need a nudge before I slip," he said.

His story stayed with me—not because it was unusual, but because it is now common for youngsters to manage their health without stepping into a hospital. What Gen Z needs is not more doctors or clinics, but a healthkeeper—i.e. a system that monitors, nudges and intervenes before their health breaks down.

We must rethink healthcare not as a system that cures, but as one that preserves. The goal should be to keep young people productive. We can do that by focusing on three levers at our fingertips: accessible technologies that bring care into homes, policy frameworks powered by integrated health data and AI systems that convert this data into timely interventions.

Digital first-aid: From smart patches that monitor glucose or arrhythmias in real-time to wearables that track sleep, heart rate, stress and oxygen saturation, The Internet of Things (IoT) has shown its power to transform healthcare in terms of where it happens and who controls it.

Most diagnostics can already be done at home; even complex radiology is on the horizon. A digital stethoscope, a BP or ECG monitor synced to a smartphone, or a cloud-linked spirometer reviewed remotely by a physician reflects a shift from episodic care to continuous, ambient health monitoring in the places where people live and work.

Government initiatives like the Ayushman Bharat Digital Mission, along with private platforms, are laying the groundwork. What we need is policy support that integrates IoT-based care with public health programmes and brings these technologies within every household’s reach, particularly in rural and underserved regions.

Let data lakes power policy: India has no shortage of health data. It’s generated in hospitals, community clinics and pharmacies, and by wearables and government schemes. But like most abundant resources, its value lies not in volume, but in how we organize and use it.

This data sitting in isolated systems with no shared language is of no help. We must connect these fragments into secure, anonymised ‘data lakes’ that prioritize privacy, consent and interoperability. Initiatives by private players, along with the government’s National Health Stack, if connected to real-world systems, can form the foundation for AI-driven decision-making and community-level early flagging of health issues.

This is how we move from anecdote to architecture, from scattered data points to a health system that sees, predicts and acts.

AI that knows when to whisper: Once structured, data becomes insight. When layered with AI, it can detect pre-diabetes from eating habits, assess speech for signs of depression, flag sleep debt through wearables and deliver nudges to prevent silent health decline before it demands clinical attention.

India has an opportunity to build AI as a companion embedded in apps, wearables and public health systems designed to steer behaviour. In a country where clinical capacity is stretched, this kind of distributed, ambient intelligence can play a vital role as a multiplier.

The healthkeeper: Beyond hospitals, healthkeeper infrastructure can take the form of an intelligent data-sharing mesh of IoT devices, AI tools and data lakes. It won’t wait for symptoms. It will watch and warn. It’s digital, but humanized. Prototypes are emerging: a homemaker tracking her thyroid level on the phone, a startup offering burnout coaching, a wearable company syncing real-time vitals to clinics. This infrastructure is taking shape; the next step is to scale it on a connected mesh.

Why the next 25 years matter: By 2047, we will have either aged into complacency or risen into resilience. India’s demographic dividend is perishable. This youth bulge will not come again. The stress they carry, if unaddressed, will show up as illness, economic loss and reduced well-being. But if we act now through the healthkeeper framework, we can change course. We can ensure that a 28-year-old today is a productive, healthy and thriving 50-year-old in 2047.

Let’s not miss the opportunity of a generation. Let our youth take charge of their health before illness takes charge of them. It is an infrastructure project that India must invest in. We must organize it before time runs out.

The author is executive chairperson, Apollo HealthCo.