The previous chapter illustrated that innovation is a process of co-production in which several institutions and interest groups involve actively. This process of knowledge production essentially is not value neutral. What is, hence, important to understand is the nature of the institutions which are involved in the co-production of innovation and their priorities. This is important in medical innovations given the mutually conflicting priorities of public health and industrial interests. As is well known, research and development (R&D), especially in the pharmaceutical sector, in its initial period was supported by government institutions, public laboratories and government grants. However, with the new patent regime the private players have started participating increasingly in drug, vaccine and medical technology development. Studies have shown that the pharmaceutical industry is one of the sectors that have high R&D spending levels (Dhar and Gopakumar 2006, Abrol et al. 2011). Studies also showed that availability of medicines and medical technology products in the market has increased significantly in India with the expansion of domestic and multinational private companies, which benefited from a facilitating industrial policy environment (Joseph 2016). However, most of the R&D activities in India remain merely a small part of the large global value chain emphasising on contract manufacturing and contract research. The focus of research in the industry, therefore, has been predominantly guided by the consideration of the Western markets (the United States and the European Union), leaving less focus on neglected tropical diseases and population (see Viergever 2013). Studies showed that only 10 per cent of domestic firms’ investment on R&D is spent on the needs of developing countries (Rowden 2013). It is, hence, not clear whether the change in the policy design, though it has increased research activity, has taken care of the public health needs of the country.

This chapter attempts to understand the disease focus of health R&D in India. It specifically examines the drugs, vaccines, medical devices and diagnostic technology R&D of private and public sector firms/institutions in India. We have extracted the data on drugs approved for marketing in India from 2001 to 2017 from the Central Drugs Standard Control Organisation (CDSCO), Government of India, to understand the therapeutic focus of drugs R&D.