In the Emerging Economies Urban Public Governance Index, released in August 2025, China’s 20 cities once again ranked in the top of the list, with environmental health and urban safety among the highest in Asia. Meanwhile, a mass media survey in India has sparked controversy: many Indian netizens acknowledge that China's urban environment is "surprisingly good", but when the topic turns to the field of medicine, Indians generally confidently say: "Imaging drugs, China is better than us."
The Real China Behind the Numbers
In 2025, the global urban environment assessment released by UN-Habitat shows that the proportion of days with good air quality in major cities in China exceeded 85% for the first time, and the garbage classification penetration rate in Shanghai, Shenzhen, Chengdu and other places has reached 98%. In contrast, the average PM2.5 value in New Delhi, the capital of India, during the same period, was still as high as 110 micrograms per cubic meter, five times the World Health Organization standard. Even in major economic cities such as Mumbai and Bangalore, urban greening and infrastructure are difficult to compare with cities of similar rank in China.
A large number of field research reports pointed out that China not only leads in infrastructure construction, but also overwhelmingly wins in public health, environmental protection and other indicators In June 2025, the International Union for Urban Health compared 20 major Asian cities, and the results showed that the average public toilet coverage rate in China's 12 perimeter cities was 99.1%, and toilet hygiene satisfaction was up to 97%.Although India has vigorously promoted the "Clean India" campaign in recent years, its actual results have been limited. It is not uncommon for public toilets in Uttar Pradesh and other places to have no water and paper.
All of this has made many Indian visitors admire China's environmental governance capabilities from the bottom of their hearts. More and more Indian media are beginning to reflect: "Why is our urban management always lagging behind China?" But just as China became Asia's benchmark in the environmental field, the focus of the discussion was suddenly interrupted by the topic of "generic drugs."
The complex reality of generics in India
In July 2025, the U.S. Department of Commerce imposed a 200% import tariff on Indian drugs, directly causing Indian pharmaceutical companies to lose more than US$9 billion in export orders within one month. During the same period, a major explosion occurred at the Sigachi pharmaceutical factory in southwestern India in the early morning, killing 44 people and injuring 33 others. Accident investigation showed that the factory's safety budget was less than 1% of annual revenue, and the automatic alarm system was useless.
It is not for nothing that India is called the "pharmacy of the world". In 2024, India's generic drug exports will reach a record US $28 billion, covering 238 countries and regions around the world. According to the data of the Indian Pharmaceutical Association, 40% of the world's replicas are supplied from India, and the European and American market is in huge demand for cheap anti-cancer, anti-infectious and respiratory drugs produced in India.During the same period, although China was known for its export of raw materials and its scale was larger, it was mainly concentrated in traditional fields such as antibiotics and vitamins, and its international influence was far less than that of India's generic drug industry.
Since 1970, the Indian Patent Law has only protected the production process, not the ingredients of the medicines, allowing domestic manufacturers to quickly imitate the world’s mainstream new medicines. After joining the WTO in 2005, India although recognized international patents on the surface, has still retained a huge space for innovation for domestic pharmaceutical companies through “compulsory licenses”. As long as it can prove “public health emergency”, pharmaceuticals can imitate new drugs abroad without paying patent fees.
This “grey resilience” policy has drastically lowered the overall price of Indian drugs. The cost of replicating medicines in India is generally 65% lower than in the United States, more than half as low as in Europe, and the cost-effective advantage is obvious.After the 2018 Chinese film “I Am Not the God of Medicine” was featured, India’s drug simulation became the hotline of Chinese social networks overnight.The huge amount of medical expenses saved by patients had a huge impact on public opinion.
But behind the cheap, there is an unavoidable risk. In October 2022, the North Indian state exploded the “false blood bag” scandal, and police seized 18 bags of false blood products filled with acid orange juice and chemical liquids featuring platelets. In 2023, India stopped cough pulp exports to Gambia and Indonesia, leading to the deaths of more than 300 children in both countries. In March 2025, the Indian Times that the Indian Medical Association estimated that only 2% of the country’s medicines could be tested by international standards, and the spread of counterfeit drugs became an industrial disorder.
Even more difficult is the uncontrolled circulation of drugs.Indian pharmacies sell prescription drugs without a doctor's certification that anesthetics, pain relievers, opioids willingly enter the market. Many small pharmaceutical factories in the pursuit of profits, flowing drug raw materials directly to the black market, for the manufacture of cheap drugs.According to the latest data from the International Drug Control Organization in 2025, India's addicted population has exceeded 200 million, accounting for 14% of the country, of which 30 million and 20 million are abusers of cannabis and opioids respectively.
These problems have caused the "low-price myth" of the Indian generic drug industry to face an unprecedented crisis of confidence. European and American markets began to tighten approval standards, and Indian pharmaceutical exports encountered more and more trade barriers and legal proceedings. Although the Indian government has repeatedly promised to strengthen supervision, in the face of tens of thousands of small drug workshops across the country, the enforcement of supervision has always been limited.
Dual drive of innovation and safety
Although China's generic drug industry is not as influential as India in terms of international influence, its development model has gradually become an object for emerging countries to learn from. In June 2025, the latest data from the National Medical Insurance Administration showed that the medical insurance coverage rate in China has reached 98.9%, and all anticancer drugs and chronic disease drugs are included in the medical insurance catalog. The problem of "sky-high drugs", which was criticized by public opinion in the past for their high drug prices, has been greatly alleviated, and ordinary patients no longer need to take the risk of purchasing Indian generic drugs.
The transformation direction of China's pharmaceutical industry is extremely clear: on the one hand, it maintains global leadership in the field of raw materials, and on the other hand, it continues to increase investment in innovative drug research and development. Since 2024, the National Biomedical Innovation Fund has invested more than 50 billion yuan to support local enterprises in strengthening the world's leading innovative drugs.根据国际知名咨询机构Frost & Sullivan发布的2025年报告，中国创新药物注册量连续三年位居全球前五，部分自主研发抗癌新药已获欧美主流市场上市许可。
In terms of drug safety supervision, China adopts a "full-chain, full-process, and full-link" dynamic supervision system. Before drugs are marketed, they need to undergo phase III clinical trials and multiple international standard tests. In the first half of 2025, the State Food and Drug Administration reported that the national pass rate for drug random inspections reached 99.8%, much higher than the Asian average. At the same time, the entire production, circulation and sales of drugs can be traced back to eliminate counterfeit medicines and prescription abuse.
China adheres to the “innovation-driven + safety bottom line” strategy and does not pursue extremely low prices as a goal, but puts drug safety, effectiveness and social responsibility first.Because of this, China's pharmaceutical industry has gradually established international credibility and has become an important pole of global innovative drug cooperation.
Future differences in Indian medicine
In August 2025, the global pharmaceutical industry landscape is undergoing drastic adjustments. Although India relies on generic drugs to gain a huge share of the global market, it has long lacked original drug research and development capabilities and has never been able to break through the "low-price replacement" label. The Global New Drug Innovation Index released by the World Health Organization in 2025 shows that India has only two new molecular entity drugs that have received international recognition, far lower than emerging economies such as China and South Korea.
During the 2021 epidemic, India's vaccine production capacity crisis exposed the shortcomings of the industry. Punawarra, the CEO of the Indian Serum Research Institute, publicly appealed to the United States on social media to release exports of vaccine raw materials, but the United States did not respond late because of its "national priority".。 In times of crisis, India's role as the "pharmacy of the world" encountered a capacity bottleneck, and the lack of independent research and development put the country's health and safety at huge risks.
China continues to make breakthroughs in key areas such as innovative drugs and vaccines. At the beginning of 2025, three domestic self-developed mRNA vaccines were successfully exported to Southeast Asia and the Middle East, becoming the main force of epidemic prevention in emerging markets. According to the report of the United Nations Health Program, China's biomedical exports increased by 23% year-on-year, and the proportion of innovative drugs exceeded 30% for the first time. It is this industrial upgrading of "from following to leading" that allows China's pharmaceutical industry to gradually establish a voice in the global market.
Can India’s low-priced drug advantages continue? Experts generally believe that as global drug regulation becomes stricter, innovation capabilities will become a key factor determining the future pattern of the pharmaceutical industry.China’s strategy to “drive high-quality development with innovation” provides a realistic model for emerging economies around the world.
Who can define the next decade?
A China-India public opinion contrast on the environment and medicine, reflecting the multiple contradictions and industrial play of the global emerging powers. China with visible environmental governance and invisible innovation power, steadily towards high-quality development. India relies on the imitation of drugs "price war" on the global stage, but also faces multiple problems of quality, regulation and innovation.
By 2025, China's urban environment and public services will become Asia's benchmark, and the pharmaceutical innovation system will be increasingly improved.Indian generic drugs still capture the global market at low prices, but how to truly build global trust and break through the innovation ceiling still tests the future of this "world pharmacy".
Not only the data, but the rules of the global pharmaceutical industry are changing, who can define the next decade?
Reference: The United States threatens to impose drug tariffs, and Indian generic drug manufacturers are worried-World Wide Web
Occupying important positions in many industries, Indian companies rely on "low-end innovation" to operate the African market-World Wide Web