India, Feb. 27 -- India may well become old before it becomes rich. That is simply a demographic, and economic, reality. Fertility has fallen rapidly, child survival has improved dramatically, and the population over 65 is expanding faster than our systems are adapting. Much of the world's increase in life expectancy over the past century came from preventing child deaths, and this has been true in India as well. However, the next frontier is about preventing premature adult mortality, and extending survival and health beyond age 65.

A 65 year-old citizen in India around the time of Independence could have expected to live another 11 years, roughly the same as in Vietnam and about a year more than in China. However, in 2020, the remainin...