In this chapter, we discuss the general state of public health in India, its achievements and deficiencies since Independence. We begin with a focus on the contemporary situation, governance issues, ethical standards and access. Following this is an examination of certain unethical alliances – medical malpractices and their impact on the subaltern population. We then profile the case of hysterectomy on intellectually handicapped females, moving on to tuberculosis, contraception, pharmacology and AIDS/HIV. We end with a broader discussion on ethics and public health. Indians at large do not enjoy the luxury of engaging in the niceties of metaethical discourse while grappling with the immediate medical and healthcare issues in everyday life. For this reason, a bioethical framework to monitor public health in the age of rapid biotechnology and medical advances so as to help sustain and not endanger a population of 1.2 billion is called for. These needs and the institutional capabilities entailed must be re-established from within India's own philosophical, moral and normative foundations, disentangled from the West's post-Enlightenment positivist-empirical project, so that it learns to function beyond the reach of the current excesses of economic utility.