The provision of accessible public health services to refugees residing in India presents a complex challenge, particularly in the absence of formal recognition under the Refugee Convention of 1951. This paper examines the state's role in addressing the health needs of refugee populations within the geopolitical context of India. By analyzing the intersection of state responsibility and geopolitics, the study explores the barriers to healthcare access faced by refugees and identifies potential avenues for policy intervention. India, as a non-party to the Refugee Convention of 1951, needs a formal legal framework for protecting the rights and entitlements of refugees. This legal vacuum complicates efforts to ensure equitable access to public health services for refugee communities. Against this backdrop, the paper highlights the critical role of the state in addressing the health disparities faced by refugees. It underscores the importance of adopting a rights-based approach to healthcare delivery. Geopolitical factors further exacerbate the challenges of providing healthcare to refugees in India. Issues such as border security, national sovereignty, and diplomatic relations with neighboring countries influence policy decisions and resource allocation for refugee health. The paper examines how geopolitical considerations shape the state's response to refugee health crises and explores potential strategies for navigating these complex dynamics. Drawing on empirical research and case studies, the paper evaluates existing public health initiatives targeting refugee populations in India. It identifies gaps in service delivery and explores innovative approaches, such as community-based healthcare models and cross-border collaborations, to enhance. Furthermore, the paper discusses the implications of geopolitical tensions on refugee health outcomes and calls for a multi-dimensional approach that integrates public health, diplomacy, and human rights principles. This paper emphasizes the urgent need for coordinated action by the state, civil society, and the international community to address refugee health access.