Why artificial intelligence struggles to reach patients?

By Rahul Gaurav, Raphaël Vialle and Antoine Tesnière

Reflections from the Indo-French White Paper on AI in Health [1], presented during the inauguration of the Indo-French Centre for AI in Health at AIIMS Delhi by French President Emmanuel Macron and India’s Health Minister Jagat Prakash Nadda

Artificial intelligence is advancing faster than healthcare systems

Artificial intelligence (AI) can now detect diseases, analyze medical images and support clinical decisions with remarkable accuracy. Yet for millions of patients, the experience of healthcare has barely changed. Waiting times remain long, access to specialists remains unequal, and many hospitals continue to struggle under growing pressure. The paradox is striking; AI is advancing rapidly, while healthcare systems often struggle to absorb innovation.

This challenge appears across very different healthcare systems, including in France and India. France and India approach healthcare from very different realities. France contributes highly structured hospitals and research systems, while India brings unmatched population scale, diversity, and experience delivering care across highly heterogeneous environments. Together they offer a unique opportunity to understand whether AI can truly function across real-world healthcare systems.

The reason is simple. Technologies do not enter empty laboratories. They enter overcrowded emergency rooms, busy hospital corridors, exhausted healthcare professionals, and healthcare systems already operating under constant pressure. In healthcare, even an excellent algorithm can fail if clinicians do not trust it, if workflows become more complicated, or if hospitals lack the infrastructure needed to use it safely.

This is why the future of AI in health may depend less on technological performance alone and more on whether these tools can become genuinely useful for patients and healthcare professionals in the real world.

The Indo-French Dialogue Behind the White Paper on AI

Over the past year, discussions between French and Indian researchers, clinicians, policymakers, entrepreneurs, and Young Leaders increasingly focused on a shared concern: why do so many promising AI systems fail to become part of routine healthcare?

These exchanges contributed to the Indo-French White Paper on AI in Health, coordinated through the France India Foundation and the Fondation France-Asie network. Because healthcare is not only a technological system but also a human system, the discussions increasingly returned to practical questions surrounding hospitals, access to care, medical training, and trust.

This reflection gained further visibility during the AI Action Summit in Paris in 2025 and later at the AI Impact Summit held in New Delhi in 2026. Across these discussions, the conversation around AI gradually shifted from technological promises toward the realities of implementation.

One question repeatedly emerged: can AI move beyond highly specialized centers and become useful in the environments where most patients actually receive care?

From Paris to Delhi: bringing AI closer to patients

A central question is whether AI can help bring better brain care closer to patients, not only to those treated in major specialist hospitals.

For many neurological disorders, diagnosis still depends heavily on imaging and expert interpretation. Yet access to these resources remains uneven. For many patients, the problem is not that medical expertise does not exist. It is that expertise remains physically too far away. In rural regions or underserved areas, patients may wait weeks for specialized imaging or neurological evaluation simply because the right equipment or specialists are not available nearby.

Portable low-field magnetic resonance imaging (MRI) systems are attracting growing interest in this context. While they are not intended to replace advanced hospital MRI systems, they could help make brain imaging available in more settings and closer to patients. Combined with AI tools, they may also help clinicians obtain and interpret images more easily. This is where AI becomes more than a technical achievement. Used responsibly, it could help reduce barriers to diagnosis and support earlier access to care for patients who remain far from specialized services.

When AI meets real hospitals

AI often performs impressively in controlled environments. Real hospitals are far more complicated. A tool that works well in one institution may perform very differently in another because of differences in equipment, organization, patient populations, or clinical routines. Creating an algorithm is only the beginning. The real challenge is making it useful inside real hospitals. It also requires systems that healthcare professionals can trust and realistically use within everyday clinical practice. Acute stroke care illustrates this challenge clearly. In stroke medicine, every minute of delay can mean the loss of brain cells. Faster image interpretation can determine whether a patient walks again, speaks again or remains permanently disabled. AI may help accelerate this, but only if the technology fits naturally into the reality of emergency care.

This is why implementation may become just as important as innovation in the future of AI in health.

Why brain health is a difficult test case

Brain health, encompassing neurological and mental health disorders, is emerging as one of the major global health challenges of the twenty-first century. It also presents some of the most demanding challenges for AI in healthcare.

Neurological and psychiatric disorders often require complex imaging, multidisciplinary interpretation, and long-term follow-up. Clinical decisions are rarely based on a single test and frequently depend on combining imaging, biological, and clinical information.

At the same time, access to brain imaging and neurological expertise remains highly uneven across healthcare systems. For many patients, expertise remains geographically out of reach. This makes brain health an important area for testing whether AI tools can function reliably across different populations and healthcare environments.

If AI can be integrated safely and meaningfully in brain health, many of the lessons will likely extend well beyond neurology.

The Indo-French centre for AI in health

On February 18, 2026, during the RUSH 2026 meetings (Rencontres Universitaires et Scientifiques de Haut Niveau), held alongside the AI Impact Summit in New Delhi within the context of the India-France Year of Innovation 2026, the Indo-French Centre for AI in Health was inaugurated at AIIMS Delhi by the President of France, Emmanuel Macron and the Union Health Minister of India, Jagat Prakash Nadda, in the presence of both countries’ ambassadors. During the event, the Indo-French White Paper on AI in Health was officially handed to President Macron as part of broader discussions on the future of AI cooperation between France and India. The discussions highlighted a shared objective: ensuring that advances in AI translate into tangible improvements in healthcare delivery, including for populations that remain underserved by existing medical infrastructures.

The Indo-French Centre for AI in Health reflects a broader transformation already underway in AI for healthcare. For years, many AI projects remain confined to conferences, laboratories, or highly specialized institutions. The challenge now is different: making AI useful for ordinary patients in ordinary hospitals. The Centre is intended as a collaborative platform connecting scientific, clinical, technological, and public-health expertise across India and France, while remaining open to broader partnerships.

Rather than focusing only on developing new algorithms, the objective is also to understand how AI systems can function meaningfully across different healthcare settings, populations, and infrastructures.

Beyond algorithms

The future of AI in healthcare will not be decided by algorithm alone. It will depend on whether these technologies can function safely, reliably, and meaningfully in the reality of everyday patient care. This requires more than computing power. It requires trust, training, infrastructure, collaboration, and a realistic understanding of how healthcare actually operates. In healthcare, innovation fails when it ignores reality.

The recent Indo-French discussions around AI in health reflect a broader international transition already underway. The question is no longer only whether AI can impress specialists in controlled environments. The real question is whether it can improve care for patients living far from expertise, inside healthcare systems already under pressure. That is where the future of AI in health will truly be decided.

[1] White Paper Indo-French Perspectives on Artificial Intelligence of the France-India AI Initiative, led by the Fondation France-Asie and the France-India Foundation.

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Dr. Rahul Gaurav is a neuroscientist at the Paris Brain Institute, Sorbonne University, working at the intersection of
neuroimaging, artificial intelligence, and brain health. His research focuses on MRI and AI-based biomarkers for
neurodegenerative diseases, including Parkinson’s disease.
Beyond his research, he advances science diplomacy and international scientific cooperation between France, Asia,
and Latin America in brain health, AI, and healthcare innovation. He played a leading role in the creation of the Indo
French Centre for AI in Health at AIIMS Delhi, was instrumental in developing the Indo-French White Paper on the First
Recommendations for AI. He also serves on the Integrated Health Steering Committee of the Indo-French Campus
for Life Sciences and Health. His work connects neuroscience, AI, healthcare innovation, and science diplomacy to address global brain health challenges. He is also France India Young Leader, 2026 cohort.

Raphaël Vialle is Professor of Pediatric Orthopaedic Surgery, Head of the Pediatric Orthopaedics Department at
Armand-Trousseau Hospital (AP-HP), and Vice Dean for International Relations at the Faculty of Health of Sorbonne
University. Long committed to fostering academic cooperation between Europe and Asia, he develops international
projects in healthcare, surgical innovation, and artificial intelligence, while maintaining a leading clinical and
research practice in the field of complex pediatric spinal deformities. He was also a Young Leader of the Fondation
France-Asie as part of the France–China 2018 cohort.

Antoine Tesnière is a French physician, professor, researcher, and entrepreneur specializing in crisis management
and public policies for healthcare innovation. A Professor of Medicine with a specialization in anesthesiology and
intensive care at Georges Pompidou European Hospital, he has long been deeply involved in research and
education, fields in which he enjoys internationally recognized expertise. He successively served as President of the
Educational Council of the Paris Descartes Faculty of Medicine and Vice-President of the University of Paris.
Driven by a longstanding interest in innovation, entrepreneurship, and digital technologies, he co-founded and led
iLumens, the first innovative healthcare simulation department developed in France, within the University of Paris.
From 2016 onwards, alongside his academic and hospital responsibilities, he became actively involved in public
policy. He first served as Health and Scientific Advisor at the Ministry of Higher Education and Research, before joining
the office of the Minister of Health in March 2020. He was also appointed Deputy Director of the Interministerial Crisis
Centre under the Prime Minister, where he helped coordinate France’s response to the COVID-19 pandemic. In April
2021, he was appointed Director of PariSanté Campus upon the joint recommendation of the Ministers for Higher
Education, Research and Innovation, and for Solidarity and Health. More recently, he co-founded French Care with
Bpifrance, with the aim of bringing together all stakeholders in the healthcare sector, fostering synergies, and
accelerating innovation to improve the healthcare system. He is a member of the France–China 2016 Young Leaders
cohort of the Fondation France-Asie

This publication reflects the views and opinions of the individual authors. As a platform dedicated to the sharing of information and ideas, our objective is to highlight a diversity of perspectives. Accordingly, the opinions expressed herein should not be interpreted as those of the Fondation France-Asie or its affiliates.