 "How India has been supplying quality drugs affordably to the entire world")
The Indian healthcare industry has come a long way since independence in the last 77 years. From being a net importer of drugs and pharmaceuticals, India today has rightfully earned its place as the ‘Pharmacy to the world’.
In the 1950s, the nation’s first-generation entrepreneurs responded to the call for self-sufficiency in drugs and pharmaceuticals and set up pharmaceutical manufacturing plants to produce medicines for the country. Today, the scenario is a vastly different one. Drugs and pharmaceuticals are the third largest in terms of exports from the country. We are currently the fourth-largest manufacturer of medical devices in the world. In terms of healthcare services, India serves as one of the medical hubs of the world, with the inflow of medical tourism increasing from 3 billion dollars in 2015 and is expected to reach 9 billion dollars by 2026.
For the past 50 years, Indian pharmaceutical firms have been successful not only in meeting domestic needs but also in achieving a leading position in the global pharmaceuticals landscape. In 1969, Indian pharma companies had a five per cent share of the market, while global pharma companies had a 95 per cent market share. However, by 2020, Indian pharma companies had a market share of 85 per cent, while global pharma companies had a market share of 15 per cent. Indian pharmaceutical industry is the third largest in terms of volume and fourteenth largest in terms of value. Four Indian pharmaceutical companies are amongst the top ten global generic companies. India is the largest generic provider globally and exports 20 per cent of generics by volume. Over 65 per cent of WHO demand for DPT and BCG vaccines, and 90 per cent of the measles vaccine is being supplied by India. Nearly 30 years after it was first spotted in Africa, HIV infection is the leading cause of adult deaths in low and middle-income countries. In the last decades, the development of new Anti-Retroviral Viral (ARV) drugs and extended access to Anti-Retroviral Therapies (ART) led to a dramatic reduction in mortality and incidence. Today, for those who have access to it, it is considered a manageable chronic illness. India is the largest supplier of affordable HIV medicines in the world. India has the second highest number of FDA-approved plants in the world, according to Invest India. In the UK, approximately 25 per cent of the medicines used are made in India, according to IPA.
We have also witnessed how health emergencies and pandemics can create turbulence in economies and generate demand for medical countermeasures on a large scale. The Covid-19 years had great learnings for us. Given the diverse nature of healthcare, simply addressing challenges in a singular manner will never help us address the problems. We need to adopt a futuristic mindset in the way we look at the healthcare spectrum to be better positioned to enable innovation and truly achieve sustainable and resilient health systems.
The Indian pharma industry was able to combat the situation through a high level of collaboration with the Government of India to ensure an uninterrupted supply of medicines. The Indian pharmaceutical industry could quickly mobilise resources to innovate and offer a solution supported by DBT’s National Biopharma Mission. Pharma companies in India made available Covid-19 vaccines at an affordable cost (range of $2.65 to $2.96 per dose- compared to regulated approximately $20 per dose) has helped mass vaccination coverage by crossing 2.2 billion doses to date.
India supplied 3.6 mn tablets of HCQs to the US and other parts of the world; as part of early Covid-19 protocols. During the Covid-19 emergency, Gilead provided Volunteering Licensing (VL) for Remdesivir to nine companies in LMICs for equitable access to Remdesivir, out of which seven were based out of India, they covered 65% of total patients treated. Price Point difference: $2,340 to $3,120 USD in HICs, Vs $60 to $400 USD in LMICs for 6 vials.
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The Covid-19 pandemic has clearly established the Indian pharmaceutical industry’s capabilities to develop and provide innovative solutions for diseases that carry high prevalence and incidence within the context of free market forces.
However, for future outbreaks and pandemics, the international community should build a wide range of tools to secure supplies. R&D funding is also critical for pandemics and for pathogens where no MCMs are available. For example, the Government of India wasted no time in creating Mission Covid-19 Suraksha to support research efforts to fight Covid-19, which led to 3 major vaccine developments for Covid-19: ZYCOV-D, mRNA vaccine of Gennova Bio, Inactivated Covid-19 vaccine of Bharat Biotech. By doing this, we have successfully established different technology platforms that will enable the country to quickly develop newer vaccines in case of pandemic/viral infections in the future. The manufacturing capacity that has been created will be able to cater to supply vaccines/medicines in case of any future requirements.
In the decades ahead, we will see more innovations emerge from India, which will bring in both access to unmet healthcare needs and make healthcare more affordable. We have already made strides with novel therapies to treat non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH). India is the first country to approve Bilypsa to treat these chronic diseases, which were an unmet healthcare need. Partnerships and collaborations can also provide an impetus to bring novel therapies to the fore. A case in point is TwinRab, a novel biologic that was developed in collaboration with the World Health Organisation (WHO) to treat post post-exposure prophylaxis for rabies. This novel therapy is now in WHO’s essential medicine lists and an estimated 29.2 million people undergo this treatment every year. With zoonotic diseases on the rise, Zydus partnered with ICMR and NIV of Pune to develop diagnostic kits for various neglected and infectious diseases. Innovations, collaborations and partnerships can create successful models of healthcare access and enhanced healthcare outcomes.
Supply challenges, climate change, human rights and ongoing global healthcare concerns are among a broad set of issues intensifying the importance of sustainability strategies across communities. The pharma industry across the globe and also in India are working towards addressing them.
With the blend of technology and sustainable practices and armed with the power of innovation, the Indian healthcare industry will continue to play a critical role in ensuring good health and well-being of people, not just in India but also in global communities. If we look at the decade ahead, we find that the application of technology is going to impact the way we look at health, patient and medical care.
Interestingly, India is home to 2,000 health-tech startups. These healthcare start-ups can address the challenges we are facing and greatly improve the quality and accessibility of healthcare in India. By leveraging technology, they can connect patients in remote areas with doctors and other healthcare providers. It also enables healthcare services to reach out to these remote areas so that patients can have better access to affordable healthcare options, bridging the divide. Digital therapeutics to treat human diseases are being approved by regulatory agencies around the world. New digital biomarkers are being created using consumer wearables, with the intent to track elements of patient health remotely.
Indeed, India fortunately has extremely talented human capital in both IT as well as lifesciences. This would place India at the forefront of medical breakthroughs and advancements as never before.
To capitalise on these opportunities, we need to have a cohesive approach that addresses multiple steps along the value chain, such as enabling innovative trial designs, streamlining regulation, to making these innovations accessible to people.
The goal should be to see how innovation can bridge gaps in our healthcare ecosystem. We also need to leverage technology and see how agile our processes can become. And most importantly, how do we keep building an environment that spurs investment in innovation while dealing with the labyrinth of regulatory framework, data privacy and security practices and intellectual property rights? With Indian innovation coming into its own and the Indian pharmaceutical industry ushering in a new wave of healthcare concepts, we will see India strengthening its position as the pharmacy to the world.
The writer is chairman of Zydus Lifesciences Ltd
Disclaimer: These are the personal opinions of the writer. They do not reflect the views of www.business-standard.com or the Business Standard newspaper