The Lancet Commission on a Citizen-Centred Health System for India presents a framework for reorienting the country's health architecture towards universal health care, accountability and trust.[1] The commission was established in December 2020 during the COVID-19 pandemic to identify the reforms needed to achieve universal healthcare in India within ten years.[3] Its guiding principle is that all citizens of India have the right to high-quality healthcare and that the government must finance, manage and operate the healthcare system.[3] The Commission draws on long-term policy developments, from the Bhore Committee of 1946 to reforms such as Ayushman Bharat in 2018.[1] The Commission's report was publicly presented on 21 January 2026 in New Delhi and represents the result of a multi-year effort to synthesize evidence and propose reform pathways.[2] The Commission's recommendations also have broader implications for health systems in many low- and middle-income countries, where quality gaps and persistent inequities exist.[1]