Vox

If you take any medication, you’ve likely taken a pill that was manufactured in India.

Future Perfect fellow Pratik Pawar was aware that India produced a lot of the world’s generic drugs. He had worked in the country’s pharma industry earlier in his life and vaguely remembered that there was some clever legal hack that led to India’s rise in the pharmaceutical market.

But it wasn’t until he further reported on that industry that he realized just how much of the world’s health now rests on that legal hack, and how shaky the foundation has become.

Pawar traced how an arcane legal change in the 1970s birthed an industry that essentially learned to crank out huge volumes of medication at rock-bottom prices. The world first took notice of it in 2001, when, at the peak of the AIDS crisis, an Indian firm offered HIV treatment for just $350 a year instead of $10,000. The result was millions of lives saved.

Since then, Indian generic drugs have become a staple in medicine cabinets around the world. But that meteoric rise has come with a cost: Indian-made cough syrups have killed hundreds of children in recent years, and the country risks getting left behind producing yesterday’s medicines for a world — and a disease landscape — that has moved on.

This matters because much of the world has come to rely on affordable Indian drugs, and if the country can’t reinvent itself, millions of people will be left stranded without essential medicines.

🎨: Mar Hernández for Vox

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