India, May 20 -- The US spends more on health care than any other country, pouring in hundreds of billions of dollars each year into research, sprawling government programmes, and high-profile initiatives. But what does it have to show for this massive investment? Skyrocketing costs, deep inequalities in access, and health outcomes that lag many developed nations. Both its medical and research systems have grown bloated and inefficient, increasingly disconnected from the real needs of patients. The US Cancer Moonshot is a textbook example of this dysfunction. Launched by President Barack Obama in 2016, with his Vice President Joe Biden championing it, the programme promised to transform cancer care - accelerating research, delivering new treatments, and saving lives. Touted as a bold mission to achieve 10 years of progress in just five, it secured over $2 billion in funding. Biden made it a personal crusade, reviving and expanding the initiative during his presidency. Nearly a decade later, the results are meagre. Announcements were made and papers published, but little came of this. In sharp contrast, India is demonstrating what true health care innovation looks like - with a fraction of the resources. Karkinos Healthcare, a private venture I have mentored and advised, set out to revolutionise cancer care with just $100 million in investor funding - a sum that would barely register in US health care budgets. And in just four years - less than the Moonshot's original timeline - Karkinos has built a nationwide cancer care network that delivers measurable, life-saving results at a scale the US programme could only dream of. Today, Karkinos operates 80 centres across 12 states, having screened more than 3 million people and diagnosed over 60,000 cancer patients. Of these, 35,000 are from remote villages and small towns that previously had no access to cancer care at all. Thousands of lives have already been saved. Unlike the US Moonshot, this is not PR spin - it's real progress, delivered with precision and impact. Karkinos's success is built on execution and smart partnerships. It collaborates with hospitals and clinics to offer screenings and diagnostics close to home, escalating complex cases to higher-level centres only when needed. Its digital backbone ensures every patient's journey is tracked and managed, closing gaps that typically plague cancer care in low-resource settings. The entire experience is mapped - like an Uber for cancer care - with everything digitised and tightly coordinated. Tumour boards review each patient's treatment plan to ensure a second opinion is always part of the process. Rates are pre-negotiated and a fraction of what insurance companies or patients would normally pay. The system is fast, efficient, and fully patient-focused. The journey was far from easy. At one point, Karkinos was in serious trouble - grappling with logistical challenges, funding shortfalls, and scepticism. Its very survival was at stake. But through determination, problem-solving, and tight execution, the team turned things around and achieved what the US could not. Meanwhile, the US Cancer Moonshot - despite its massive budget and high-profile promises - delivered little more than press releases and committee meetings. I saw this complacency firsthand through my interactions with its leadership, including a White House meeting and extensive follow-up discussions. My goal was to advocate for collaboration with India, highlighting the technology Karkinos had built and the treasure trove of medical data it had amassed - offered freely as part of a groundbreaking partnership. But instead of seizing this chance to leap forward, the Moonshot team reverted to its usual routine. It handed out grants to favoured researchers who churned out academic papers with little practical impact, and endlessly scheduled meetings with other government bureaucrats, brushing off India's capabilities with thinly veiled condescension, as if it couldn't possibly have built world-class technology. The sense of urgency was all for show. Patients continued to suffer - and die - while the government's machinery crawled along at its usual pace. The Moonshot's failure is not unique; it reflects a deeper issue. The US health care system is addicted to funding academic research and pilot projects that rarely scale. There is a reluctance to focus on the hard, unglamorous work of delivering proven solutions at scale. The result? A system long on discovery but painfully short on meaningful impact. Karkinos offers a different path, solving real-world problems now, at scale, and using existing technologies. It is a model driven by necessity and ingenuity - and it is working. With Reliance Industries acquiring Karkinos and Mukesh Ambani compassionately backing its expansion, the company is set to scale rapidly. Reliance brings the capital, reach, and operational expertise to take the Karkinos model across India - and eventually to other countries. What began as a bold health care startup is fast becoming a blueprint to deliver cancer care - and healthcare more broadly- effectively and equitably. America spends nearly 18% of its GDP - over $4 trillion annually - on health care. Yet, it delivers poor outcomes. Even more troubling is how much of that funding is tied up in research that rarely translates into real-world improvements. India, too, faces calls from international experts to pour more public money into research. But rather than copying the US model of research for its own sake, India's policymakers should focus on what is already working -- government-industry partnerships built for execution, scale, and results. The world doesn't need more Moonshots that fizzle out; it needs more Karkinos-style revolutions that deliver....