Not independent, but more inter-dependent than ever before

India will be marking her 75th Independence Day next year but preparations will start from this year. The momentous milestone is a good time to take stock of where we have reached as a nation, how far we have come from 1947, and, how far we still need to go.

Further, it is clear from our cover story in the August edition of Express Pharma, that our pharmaceutical sector has indeed come a long way. However, we have an even longer and harder road ahead. The story focusses on our dependence on other countries for active pharmaceutical ingredients (APIs) even though we proudly proclaim ourselves to be the pharmacy of the world. That claim rings hollow, as we struggle to cope with the demand for COVID-19 vaccines, even though the world’s largest vaccine manufacturer is India-based.

It is time for introspection on where our policies fell short of meeting the healthcare needs of our nation. As many experts have pointed out, we have policies but we fail to implement those forcefully and swiftly enough. A case in point being the fact that 2015 was declared the Year of the APIs, when India was supposed to implement a blueprint that would ramp up the production of bulk drugs and APIs. However, after a high decibel start, the plans gathered dust. Imports of APIs and bulk drugs increased over the years.

Ultimately, it took a to finally shake off the policy paralysis. Let us hope we emerge wiser. Let us hope that the COVID-19 pandemic lays the ground work for a better future. The Production Linked Incentive (PLI) schemes are still flawed but let us hope that the public scrutiny will force their implementation with the necessary tweaks.

Let us hope that the judiciary continues to take the government, both at the centre and the state level, to task for tardy vaccination schedules. On the intellectual property side, a Parliamentary Standing Committee on Commerce has reportedly recommended that the government should consider invoking Compulsory Licensing (CL) so that medicines and vaccines required to treat COVID-19 are not hampered. The Committee recommendations cite the national health emergency triggered by the pandemic in India, even while advising a careful stance while issuing CLs.

Indeed, there is a move to propose Voluntary Licensing (VL) as a more viable and pragmatic access mechanism, as there are several examples of VLs for COVID-19 medications. But while these VLs may have increased access to medication, these have not addressed the issue of equitable access and definitely have not been cost effective.

India and South Africa have championed a similar move globally, and while the two have been joined by more than 100 countries in their demand for a TRIPS waiver on technologies used to make COVID-19 medicines, opposition continues to be stiff.

Clearly, India’s tryst with destiny and disease continues. Will we forfeit a chance to enter the big league if we champion the cause of low- and middle-income countries, which do not currently have pharma and vaccine making prowess? The pandemic has proved that no country is truly independent. Our identity as citizens of the same planet connects us all, held ransom by the same virus. Just as we have not been truly free of polio even after years of vaccination campaigns, we might never be truly free from SARS CoV 2. This is a sobering thought as we approach our 74th Independence Day.