India is famously referred to as the ‘pharmacy of the world’ accounting for more than 40 percent of the generic drugs produced globally. India’s pharma exports are versatile and include bulk drugs, intermediates, drug formulations, biologicals, surgical as well as herbal products. Indian pharma industry also supplies over 50 percent of the global demand for vaccines. Naturally, India’s role as a supplier of drugs assumes great significance at a time of a global pandemic. 

India’s prowess in supplying affordable drugs to millions of people globally has over the years helped it earn immense goodwill in the developing and developed world. COVID-19 has further cemented this image. With the unprecedented health crisis nudging the pharmaceutical industry towards a longer-term restructuring, it has also impacted the future of pharma itself.

India led from front             

As the world battled a never health threat in coronavirus, India’s dependable pharmaceutical sector has risen to the occasion. In recent months, Indian pharma manufacturers have ramped up trials and production of drugs being used in COVID-19 treatment globally. Several Indian pharma companies have received approvals to produce and market re-purposed drugs after trials for their utility in managing the COVID-19 epidemic. The US-based Gilead Sciences has entered into agreements with at least six Indian pharmaceutical companies to manufacture Remedesivir for distribution in 127 countries. Production of hydroxychloroquine or HCQ has been ramped up with global demand skyrocketing. Going by a recent assessment, the country possesses the capacity to produce nearly 40 tonnes of HCQ in a month, a dominant 70 percent of the world’s total supply. 

India has not only led from the front in fulfilling global demand for affordable, high-quality generic medicines. Recognising the immense goodwill accruing from such activity,  the Indian government has launched a major health diplomacy drive as part of an integrated response to fighting coronavirus. Medical aid worth USD 5 million was sent to over 154 countries including our immediate neighbor’s, Africa, Latin America, Central, and Western Asian regions. Medical supplies comprised HCQ and other essential drugs such as paracetamol, life-saving antibiotics, testing kits, and medical equipment. HCQ is also being supplied as commercial exports to a large part of the world. An estimated 445 million doses of HCQ have been exported to over 60 countries. To achieve this task, production has been scaled up significantly and export clearances sped up for HCQ and paracetamol. India is also providing technical assistance to a few countries requiring rapid response teams of doctors, nurses, and paramedics. 

Another crucial element of India’s health diplomacy was the enormous help provided in evacuating and repatriating over 60,000 foreign nationals from more than 70 countries that were stuck in India due to the pandemic. While all this flurry of activity was underway, the top leadership led by the Prime Minister Narendra Modi himself continued to engage with world leaders. Prime Minister Modi addressed the virtual G20 Leaders’ Summit in March and the NAM Contact Group in May.      

Exhibited regional leadership through SAARC

India also took it upon itself to get the South Asian Association for Regional Cooperation (SAARC) member countries to work out substantive arrangements among themselves to deal with the pandemic. A series of initiatives were undertaken to boost health cooperation within the regional grouping including setting up an emergency fund with an initial contribution of USD 10 million. Besides this, a collaborative cross border WhatsApp group of doctors was created to set up communication on disease surveillance and patient management, besides an information exchange the platform for online training, activation of the e-iTEC network for knowledge exchange. By early June, India had supplied medical aid worth about Rs 12 crore to SAARC members.  

Future of pharma

The pandemic has had its share of ill-effects on the pharma industry. Smaller companies particularly took an initial hit facing a dip in production, supply chain disruptions (cross-border and domestic), reduced ability to strike deals with other businesses, minimal movement of labour due to stringent social distancing, and delay in approvals. Some of these issues also challenged larger companies. 

Nonetheless, given that pharma as a sector is resilient, a negative long-term impact on this sector is unlikely. It will continue to register impressive growth rates, as always. The race to discover the vaccine for COVID-19 will also give a fillip to research and innovation with priorities on preventive health prevailing over curative health. Indeed, there will be a shift towards online pharmacies and higher uptake of digital/telemedicine facilitating patient convenience. The interoperable technological universe of AI, data, and open and secure platforms will in the long run also lead to greater personalisation in healthcare services. Furthermore, alarmed by India’s overwhelming import dependence on imported particularly active pharmaceutical ingredients (APIs), key starting materials (KSM) (70 percent) from China, the government has decided to incentivise domestic production with end to end manufacturing. Import duties are also likely to be enhanced... About 53 APIs and KSMs have already been identified apart from the decision to commission integrated pharma and medical device manufacturing clusters in three states. Further policy stimulus and assistance through easier tax, financial, and export norms would be a shot in the arm for the sector.   

Diplomacy is all about reciprocity driven by mutuality of interests. With the nature of threat being common in an integrated global community, the vast reservoir of goodwill earned by India would stand the country in good stead. The Indian pharma sector would be a valuable partner as well as a beneficiary, whenever that happens.  

(The writer is President, Council for Healthcare and Pharma, which advocates the development of sustainable healthcare systems around the world. The views expressed are personal)