By DK Giri
India saved a large part of the world in the pandemic. During Covid-19, it shipped 300m vaccine doses to 100 plus countries under ‘Vaccine Maitri’ (Vaccine Friendship). The Global South called it a lifeline. That was potential made real at the time of a health crisis. But the potential is not leadership. It is actualising the potential and creating scope for further action and support.
A NITI Aayog report puts it bluntly: India is one of the world’s largest suppliers of generic medicines and vaccines. Yet, our global export share in pharmaceuticals and APIs remains just 2.8 per cent. The 2.8 per cent share in pharma exports is both our drawback as well as a runway for greater accomplishment. Keep in mind, global pharma market was 1.6T USD in 2025, biologics alone 450b USD. The context and scope for health intervention is increasing globally: ageing West, rising South, disasters and pandemic lurking. The question is not if India can lead, it is how and how fast, given the potentials existing in India.
The pitfalls which hold back emergence of India as a leader in healthcare are largely structural, and to some extent, circumstantial. The latter is mainly shifting of global pharma to high-value segments – biologics, mRNA, cell and gene therapy, immunologicals, patents, 80 per cent margins, brutal regulators. In these areas, India’s export regime is thin. The structural drawbacks comprise the following:
API Dependence: 70% of APIs and 90% of key starting materials are procured from China. One Galwan type incident and Lagos loses HIV drugs. Production Linked Incentives (PLI) covers 53 APIs, but we’re 5-7 years from security.
Second, Regulatory Trust Deficit: Indian firms got 42 USFDA import alerts in 2023-25 vs 12 for EU. The Gambia cough syrup deaths in 2022 did to “Made in India” what Maggi did to noodles — one tragedy, global memory.
Third, R&D Gap: India spends 0.7 per cent of pharma sales on R&D compared to global spending of 8-10 per cent. India is perceived great at process innovation but poor at product innovation. There are zero Indian-origin drugs with $1B global sales.
How does India make-up these drawbacks? Obviously, it calls for a shift in strategy from one geographical area to another. In Africa, India needs to move from exploring the market to becoming a manufacturing partner. Africa is not just a buyer. It’s 1.4B people, 25 per cent of global disease burden, 2 per cent of drugs made locally. It imports $16B pharma yearly — 80 per cent from India and China.
Second, stop selling, start co-producing. Vaccine Maitri 2.0 = Technology Maitri: Serum + Aspen South Africa already do fill-finish. Scale it. India should set up 5 vaccine hubs in Kenya, Nigeria, Rwanda, Senegal, and Egypt. Transfer mRNA, not just vials.
Third, ARVs & Malaria: 70 per cent of Africa’s Antiretrovirals (ARVs) are Indian. Shift from export to JV plants.
Fourth, use AfCFTA – African Continental Free Trade Area – if made in Ghana, sell duty-free to 54 nations.
Fifth, climate-proof drugs: Africa needs drugs that survive 45°C, patchy power. India’s frugal R&D edge: heat-stable insulin, vaccines without -80°C. We should sell resilience, not just molecules.
The leadership test is reflected in Prime Minister Modi’s statement at G20 health summit, 2023: “India’s vision is One Earth, One Health. During Covid, we saw that when India grows, the world benefits.” This was endorsed by WHO Director-General Dr. Tedros who added during Vaccine Maitri: “India’s capacity to produce vaccines at scale has been critical for global equity. The world needs India’s continued leadership.” The scope is awaiting, New Delhi needs to grab it with both hands.
The writer is Professor of Practice, Institute of Management Bhubaneshwar.
