India's pharmaceutical industry, often hailed as the "pharmacy of the world," is grappling with a decline in voluntary licensing and technology transfer agreements, according to the latest Access to Medicine Index 2024. Published biennially by the Access to Medicine Foundation, with support from the UK Foreign, Commonwealth & Development Office and the Dutch Ministry, the report highlights challenges impacting global access to affordable medicines.
Historically, India has played a pivotal role in supplying cost-effective generic drugs to low- and middle-income countries (LMICs), sustaining global healthcare systems. However, the report raises concerns over a reduction in non-exclusive voluntary licensing agreements, which allow other manufacturers to produce patented medicines at reduced costs. This decline could hinder the availability of essential medicines in resource-constrained regions.
Additionally, technology transfers—critical for enabling local medicine production—are predominantly concentrated in high-income countries, leaving regions such as sub-Saharan Africa vulnerable to medicine shortages. This trend underscores a growing inequity in global healthcare delivery.
Despite these setbacks, India remains a cornerstone of global pharmaceutical manufacturing. Out of 20 leading pharmaceutical companies assessed in the report, five have established production facilities in India, reducing costs and bolstering supply chains. Furthermore, India has participated in 11 of the 47 international technology transfer projects, including initiatives focused on complete production capabilities.
One notable collaboration is between Takeda and India-based Biological E. Limited to produce the dengue vaccine QDENGA® (TAK-003). This partnership aims to manufacture 50 million doses annually by 2030, addressing India's substantial dengue burden, which accounts for 59.5 disability-adjusted life years (DALYs) per 100,000 people.
Claudia Martinez, Director of Research at the Access to Medicine Foundation, stressed the need for pharmaceutical companies to take more active steps to promote health equity. “There are clear opportunities for companies to expand access and address disparities, but more deliberate action is essential,” she stated.
Martinez also called for inclusive business models, increased voluntary licensing, diversified clinical trial locations, and expanded technology transfers as effective strategies to bridge the access gap. “Real progress requires companies to reassess their policies and align them with access equity goals,” she added.
While challenges persist, the report underscores India’s vital role in global healthcare and the untapped potential of partnerships to address pressing healthcare needs in LMICs.