Given the long history of infectious diseases in India, the scientific community in the country has started to explore the potential of new biotechnologies – i.e., gene editing, synthetic biology, genomics—to develop products that can prevent and treat them. To leverage India’s biotech sector, a regulatory system is needed to support India’s homegrown technologies that backs up manufacturing and research capabilities to produce safe and effective healthcare products.
This session convened scientists, industry leaders, and representatives from the government and non-profit organizations to discuss India’s strengths, weaknesses, opportunities, and threats in relation to its contribution to global health security (GHS). The discussion highlighted strategies that can be developed to support India’s indigenous biotech sector for it to remain an active player in this space globally. Further, it also noted the kind of financial and political support that is needed to support homegrown technologies.

The meeting was moderated by Gagandeep Kang, professor of microbiology at the Christian Medical College.

Discussion Highlights 
• Strengths of India’s healthcare sector: India, due to its low manufacturing costs, is recognized as the generic pharmacy of the world. This status can make it an active player in health diplomacy. India should draw on its manufacturing capacity to develop products that cater to its own population and that of its neighborhood, noted participants. They further discussed that apart from the traditional hard-line security considerations, health should be at the front and center of India’s diplomatic agenda. From a country with thousands of years of investment in health and wellness, India has the potential to collaborate and exchange its experiences at global forums and share best practices in clinical care and management, emergency response, biotechnology, and clinical trial experimentation, noted experts. India should therefore support its local organizations and pick the right allies for it to establish leadership at the diplomatic level, discussed participants.
• Weaknesses of India’s healthcare research ecosystem: Although a few scientists in India have begun to explore the potential of new technologies such as gene editing or synthetic biology to develop healthcare products, India does not have a conducive platform that supports bold ideas both in academia and industry. This limits India’s thought leadership at global platforms, added participants. They discussed India’s need to create a new generation of scientists and entrepreneurs who can think about the public health applications of biotechnology. Further, they observed that most scientists in India work in-silos and often do not engage in collaborative projects. As a corrective measure, participants suggested that India should create a research ecosystem that supports and invests in bold ideas for it to become a global leader. They further added that India requires a national program with the right financial and policy structure that invests in training and quality mindset that we need to be a global innovator. Such a program will require active conceptualization and multistakeholder discussions, an initiative that Carnegie is focused to build upon.
• Opportunities of India’s healthcare ecosystem: No other country can scale as much as India, and it is therefore important to boost its manufacturing capacity to meet both local and global commitments, discussed participants. Apart from strengthening its manufacturing capacity to develop generics, it is imperative to create a workforce that is invested in research and development alongwith response and delivery during an emergency. India should improve its data sharing within and amongst industry and academia to build a strong clinical trial research ecosystem. It should also increase its financial investment—both public and private—to enhance the scale of its innovation capacity, emphasized participants. Further, If India addresses its own health priorities, such as tuberculosis or neglected tropical diseases, and strengthen its innovation in diagnostics, it has the potential to help the world, noted participants. To strengthen its position globally, India should think about GHS as a long-term goal and should invest in an ecosystem that ensures global reliability of products being manufactured in India. Further, it should also leverage its regional connections to create a web of cross-learning that is open to sharing lessons learned locally to build scientific prospects for pandemic preparedness and response, added participants.
• Threats to India’s healthcare sectorParticipants noted that India lacks an area-specific scientific roadmap for biotechnology and does not have adequate innovation funds or risk-funding mechanisms to strengthen its capacity to scale up innovations in case of an emergency. This makes it difficult to produce globally competitive products, they added. Participants further discussed that India’s complicated regulatory infrastructure (both at the central and the state level) sometimes results in high compliance burdens for homegrown companies, making it difficult for them to produce low-cost quality products. Participants discussed that this might be one of the primary reasons that the scientific community in India still relies on foreign reagents and equipment for their research. They, therefore, recommended that India should introduce legislation to replace the archaic Drugs and Cosmetic Act of 1940 to promote production of safe and effective products in a cost-effective manner. This legislation can be based on experiences and challenges of the Indian healthcare industry and can act as a template for the Global South, which can showcase India’s regulatory leadership, they noted. In addition to internal threats, experts also discussed the changing geopolitical alliances and disrupted global supply chains that has the potential to threaten India’s healthcare sector.
Disease surveillance capabilities in India: Participants discussed that there is reservation among industry to share data with people who can work together. Moreover, there are multiple organizations that works in silos across the local, state, and national level that collect data for the same disease but with differing case definitions and limited coordination. Participants suggested that it is important for India to invest in an integrated disease surveillance mechanism with better data sharing protocols to draw correlation between data points that can be used as a scaffold to develop intelligence mechanism to prevent future pandemics. To prevent infections from jumping from animals to humans, participants discussed the importance of ‘One Health,’ which is a collaborative approach that breaks the silos between animal, human, and environmental health. They further suggested that research and development should be linked with health intelligence, which is imperative to preventing future pandemics, noted participants.