Can India be the “Vishwa Guru” of Global Pharma needs? It may have fancied itself as one in drug delivery in the world until a few months ago. However, the image seems to have been shattered in the quest to reach the virus curing vaccines to all and the debilitating second wave.
January this year saw US in its third wave as severe as the one we are experiencing now and European countries locked down for the third time. Even UK numbers had exploded with new variants that were very infectious. In contrast, our COVID-19 numbers had declined to almost 1/10th from a peak of 96,000 daily infections in September last year. The death rate was also down from 1200 to 80. We were also touted as one of the largest manufacturers of vaccines in the world. What However, we saw as COVID cases increased suddenly in April, was that the supply chains and logistics were simply inadequate.
How did we land in the current mess of having to import vaccines and lifesaving drugs then? Complacency and triumphalism in large measure. Our “Vishwa Guru” chant was uttered a little too soon and obviously faltered somewhere. Can we retrieve the situation and claw back into the comity of Nations doing well and be the supplier of vaccines and drugs rather than be at the receiving end, literally and metaphorically assuming the pandemic will ebb at some point of time?
What must we do to change, so we continue to matter not only in drug delivery but also in its development? In terms of the highest dollar value worth of drugs and medicines exported during 2018, Germany led with $62.3 billion, US came third with $22 billion, and India with $14.8 billion was 10th. By value, 14 countries ship 85% of all exported drugs and medicine while India has a share of 3.8%. It is However, comforting to know that we are one of the fastest-growing exporters since 2014 up by 22.5%. About 40% of Indian exports are predominately to the US, the UK and South Africa. Though the research and publications from India have grown, they are only a third of what USA and China produces. Once we declare an intention to be at the helm of the Pharma Ship, we need to excel in all aspects of its eco-System. The health care budget will have to rise manyfold from the current 0.35% of GDP. Contrast this. US spends 4.6% and China 6.4% of their GDP.
The government must surely have a proactive R&D policy for the pharmaceutical sector if it has to compete with USA and Europe. Several opportunities are available for Indian vaccine and drug manufacturing companies, when one considers the knowledge base, cost of production and skilled labor.
Drug development needs high investments and innovation in R&D. Though US accounted for 42% of prescription drug spending and 40% of the total GDP among innovator countries and was responsible for the development of 43.7% of the New molecular entities (NMEs), Indian drug companies too have been investing in new drugs and medicines. Sun Pharma Advanced Research Company (SPARC) invested 587% followed by Suven Life Sciences, which spent 304% of its revenues on R&D last year. That the Department of Pharmaceuticals’ (DoP) vision of developing India as a drug discovery and pharma innovation hub augurs well for the country. Further, that UAE is an able ally in this pursuit is a plus. Very high R&D costs, reduced healthcare costs apart from other factors are the current dampeners on global pharmaceutical companies. In this milieu, should drug companies drop their patents and collaborate to fight coronavirus is a question fraught with possibilities and long-term implications.
Can we create a culture of Innovation in Health Care that has no parallel in the world? Of course, it requires ramping up the manufacturing facilities for vaccines and generic medicines. However, in order to build such a culture of innovation and superior drug development, there needs to be a cultural transformation. There are Multiple players apart from the Government, the Academia, students, Start-ups, venture capitals, Communities, NGO’s, Private Sector, Partnerships and Philanthropists who can make it happen. What should their role be in a sector which is as dynamic as any and ever changing?
Apart from the many players it comprises of, a health-care ecosystem can only thrive if the Government takes the lead. What must it do? For a start, it must put in place policies and protocols that enable fair and equitable health care for all. This needs vision and objectives that define wellbeing of citizens and the needs of R&D. Gaps in R&D will need to be identified by the private sector and academia, inputs coming from communities. The Government must directly fund R&D activities which enable development of drugs not developed by private industry. It needs to support and incentivize academia and private sector R&D, new drugs development and digitalization of health care. It needs to oversee the regulatory and ethical standards in R&D organizations. The Government together with communities, universities, and private sector must nurture an enthusiastic culture of innovation that supports research in new areas and aids development of new drugs. All possible, only if it encourages partnerships between universities, private sector and philanthropists. Appropriate incentives can then spin off Start-ups.
A significant learning recently is that, Supply chain and its digitalization are as important because they govern the eventual distribution of the drugs to the people. Innovation in this area will pay big dividends. A big learning is that contingency plans need to be developed for each particular disease and should be based on the severity of the impact. Such plans need to be developed with all the players in the Eco System and should extend it to the other Eco Systems, such as transportation and logistics sectors. When such plans are developed, there will be clarity on how the nation will work in emergency vs normal times. This is essential, as the private sector will normally be focused on normal situations and sales due to profitability issues. Examining the Eco System will also provide other benefits of identifying mission critical areas where Small Businesses can thrive leading to R&D innovation in areas not conceived before, leading to superior benefits. Only then, a Pharma eco-system can truly flourish. The world will then cherish us as a true “Vishwa Guru”