The Indian pharmaceutical industry has played an important role in the development of generic medicines (Farmer 2001). However, whether those who are heavily dependent on the public sector benefit from this advancement made by the industry is a critical question for several reasons. First, as is well known, the bulk of these generic drugs are exported to international markets and are inaccessible in India (Swain et al. 2014). Second, the market is dominated by branded generics, which are usually priced higher than their corresponding generics (Mathew 2015). The quality of essential generic medicines that are available in the public sector has been also under question (Bate et al. 2009). The prospect of drug development in India assumes paramount significance for public health in this context. This chapter discusses in detail whether drug and vaccine development in India is responsive to the disease burden of the population, epidemiological changes and accessibility of services. To begin with, we present the data on disease burden in the country from 2000 to 2015 and juxtapose the therapeutic focus of the drugs approved for marketing, the new chemical entities (NCEs) in the pipeline and vaccines. The data on disease-specific mortality are collected from the mortality database of health statistics and information systems of the World Health Organization (WHO) for the years 2000, 2005, 2010 and 2015. These data are further disaggregated across four age groups. Data on morbidity are extracted from the National Sample Survey Organisation (NSSO) 71st round on health in India (2014). Data on drugs approved for marketing are compiled from the Central Drugs Standard Control Organisation (CDSCO), Government of India.

Causes of deaths in India: a detailed analysis

We have extracted the data of causes of deaths for the years 2000, 2005, 2010 and 2015. As Table 3.1 shows, non-communicable diseases (NCDs) constituted the highest cause of deaths in all these years as compared to communicable diseases (CDs). Furthermore, there is a steady increase in deaths due to NCDs along with a decline in mortality due to CDs in general in the line of the trend of epidemiological transition. For instance, the share of NCDs in total deaths increased to nearly 61 per cent in 2015 from 46 per cent in 2000. Similarly, share of NCDs was reduced to nearly 21 per cent in 2015 from 30 per cent in 2000. The share of injuries and accidents in the causes of death also marginally increased during this period. Table 3.1 presents the causes of death for males and females. As the table shows, the trend of dominance of NCDs was true for both males and females. However, the burden of CDs was found to be more on females than males.