INDIAN MANDALA India, the world’s pharmacy aiming for self-sufficiency

More than 60 Gambian children have died after consuming toxic syrups produced in Haryana. One third of the drugs traded worldwide come from the Indian subcontinent. The development of the pharmaceutical sector has been possible thanks to “reverse engineering” and process patents. The Indians also want to break away from China for the production of active ingredients.

Milan () – The Indian government ordered an investigation after the World Health Organization linked the death of 66 Gambian children to the consumption of four cough syrups produced (for export only) by Maiden Pharmaceuticals, the company whose home matrix is ​​located in the northern state of Haryana. According to a statement from Delhi, the National Medicines Regulatory Authority launched the investigations after being contacted by the WHO on September 29. However, the Gambian authorities had raised the initial alarm in July, when many children were hospitalized for serious kidney problems. According to WHO Director-General Tedros Adhanom Ghebreyesus, the syrups caused kidney damage because the drugs contained “unacceptable” levels of toxins.

The truth is that in the past seven years, at least six drugs produced by Maiden Pharmaceuticals failed to meet safety and efficacy standards required for marketing. Of these, four were declared unfit in the last year.

India produces a third of the medicines consumed worldwide and is home to some of the fastest growing pharmaceutical companies. To understand how this situation came to be, one must go back to the 1970s, when the government introduced the Patent Law, legislation that recognized process patents but not product patents. Therefore, Indian pharmaceutical companies could produce equivalent drugs without being forced to pay royalties to the original patent holders. In a few years, the sector exploded: from the 2,200 pharmaceutical companies present in 1970, the country had 24,000 in 1995. To meet the demand for experts in the sector, Indian universities multiplied the offer of pharmaceutical courses.

In 2021, the Indian pharmaceutical market, which today moves around 42,000 million dollars, grew by 17.7%. It is estimated that it could grow to 65 billion dollars in 2024 and even triple, reaching 120-130 billion dollars in 2030.

Since the 1990s, exports have played a fundamental role: today, India covers half of the world’s demand for vaccines, 40% of the demand for generic medicines in the United States and 25% of that in the United Kingdom. This means that one in three pills ingested in the US and one in four in the UK are produced in India.

The ability to develop generic drugs at a reduced price is due to the large availability of skilled labor. Through “reverse engineering”, India has succeeded reproduce drugs against AIDS (Zidovudine) or cancer (Imatinib) a few years after its launch in the United States. On the other hand, it managed to reduce the prices of some drugs by up to 99%, making them available even to low-income countries, especially those in Africa. 80% of antiretrovirals to combat HIV worldwide are produced by Indian companies.

India is also a major exporter of vaccines, as the Covid-19 pandemic has shown: according to government data, since May India has supplied more than 201 million doses to some 100 countries. It is estimated that 65% of the world’s children have received at least one vaccine produced by the well-known Serum Institute of India (SII). This institute suspended the export of AstraZeneca vaccines from April to October last year to meet domestic demand: only 0.5% of the Indian population she was vaccinated when the second wave swept the country.

Some maintain, however, that the true pharmacy of the world would be China. India imports from China 68% (or according to other estimates 85%) of the active ingredients that make medicines effective. However, something has begun to change: thanks to a government plan implemented in 2020 (at the height of border tension with China), since March of this year India has begun to produce 32 active ingredients at the national level in 35 plants throughout the country. . The short-term goal is to reduce dependence on China by 35% by the end of the decade. Delhi has also earmarked $2 billion in incentives to encourage the production – by domestic and foreign companies – of at least 53 active ingredients currently imported from Beijing. In the long term, what India seeks is to achieve almost total self-sufficiency in its production.

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