India, March 12 -- 'The past is never dead. It's not even past.' William Faulkner's words about the American South apply to India's health system as well. Much of how the Indian State governs disease, regulates medicines, structures public health administration, and even distributes health resources is rooted in priorities shaped during British rule.

Much has rightly been made of the systematic transfer of wealth from India to Britain during colonial rule. Less often discussed is the systematic underinvestment in the health of the population being ruled. That neglect depressed life expectancy at Independence but also helped create institutional hierarchies and regional disparities that persist to this day.

Consider the legal backbone of...