India proudly wears the badge of being the “pharmacy of the world.” And on the surface, that claim holds up. Indian companies ship affordable generic medicines to more than 200 countries. But beneath this success lies a vulnerability we don’t talk about enough. While India manufactures the pills, it doesn’t produce enough of the ingredients that actually make those pills work.
Those ingredients are APIs, or Active Pharmaceutical Ingredients, the chemical compounds that give a drug its therapeutic punch. And APIs themselves depend on Key Starting Materials, or KSMs, which are the raw inputs used at the earliest stages of production. Think of it this way: if a finished medicine is a cake, APIs are the batter, and KSMs are the flour, sugar, and butter that go into it.
The problem is that for many critical APIs and KSMs, India sources 60–70% of its supply from China. In some cases, the dependence is nearly total.
How India Gave Up the Chemical Backbone
This dependence didn’t happen overnight. In the 1980s, India actually produced most of its APIs domestically. But over time, the economics began to shift. Environmental compliance became stricter, power and utility costs rose, and Chinese manufacturers started flooding the market with far cheaper alternatives.
By the late 1990s and early 2000s, it simply made more business sense for Indian pharma companies to focus on formulations, the finished drugs rather than the messy, capital-heavy chemistry behind them. Gradually, the bulk of API and KSM manufacturing was outsourced to China. It was efficient, cost-effective, and for years, it worked just fine.
Until it didn’t.
The Pandemic Wake Up Call
COVID-19 exposed the fragility of this setup. When Chinese factories shut down, the supply of common APIs dried up almost instantly. Prices of everyday drugs like paracetamol and azithromycin surged. Indian manufacturers were forced to slow production, and the so-called pharmacy of the world realised it didn’t control its own supply chain.
That shock triggered a long-overdue question: what happens if China stops supplying the raw materials?
India’s Attempt to Rebuild API Manufacturing
The government’s answer came in the form of a ₹7,000 crore Production Linked Incentive scheme aimed at reviving domestic API and KSM production. Alongside this, three bulk drug parks were approved in Gujarat, Andhra Pradesh, and Himachal Pradesh to lower infrastructure and compliance costs for manufacturers.
Some companies responded quickly. Aurobindo Pharma commissioned a ₹2,400 crore facility to manufacture Penicillin G, a widely used antibiotic. Others, like Sun Pharma and Alkem Labs, began producing clavulanic acid, a key component of Augmentin.
In just two years, close to ₹3,000 crore has been invested under this push. On paper, it looks like momentum is building.
But here’s the catch, this still doesn’t meaningfully dent India’s dependence on China.
Why China Is So Hard to Replace
China’s dominance in APIs isn’t accidental. It’s the result of decades of deliberate policy choices. As far back as the 1990s, China treated pharmaceuticals as a strategic industry. It offered cheap land, subsidised utilities, easy credit, and export-linked tax benefits. Over time, thousands of API manufacturers emerged across provinces like Jiangsu and Zhejiang.
The real breakthrough came when China solved the environmental challenge. While Western countries pulled back from bulk drug manufacturing due to pollution concerns, China built dedicated chemical industrial parks with centralised waste treatment. This allowed manufacturers to scale production while keeping compliance costs low.
Just as importantly, China built dense ecosystems. KSM suppliers, intermediate processors, and API plants operate close to one another, slashing logistics costs and reducing production delays.
The Resource Advantage No One Talks About
There’s another layer to China’s edge: raw materials. Pharmaceutical chemistry relies heavily on specialty chemicals and rare earth elements used in catalysts, fermentation, and purification processes. China controls around 60–70% of global rare earth mining and dominates processing almost entirely.
That means Chinese API producers don’t just have cheaper access to these materials but they have assured access. For manufacturers outside China, sourcing these inputs consistently and competitively is a constant risk.
Labour and Infrastructure Seal the Deal
Labour costs further tilt the balance. According to World Bank data, if a Western API manufacturer has a wage index of 100, China sits around 8 and India around 10. That gap matters immensely in a cost-sensitive industry.
Infrastructure is the final piece. Chinese API clusters integrate utilities, solvents, power, steam, and waste management within the same industrial zones. Indian manufacturers, despite recent progress, still face higher input costs and inconsistent utilities outside a handful of new parks.
Put together, China’s advantage rests on four pillars: policy support, access to critical minerals, low-cost labour, and deeply integrated infrastructure.
Where India Stands Today
India mastered formulations, branding, and global distribution. China mastered chemistry, scale, and cost control. And while India became indispensable to global healthcare, it quietly ceded the most capital and energy-intensive parts of the supply chain decades ago.
Rebuilding that capability isn’t quick. It requires massive scale, reliable utilities, environmental compliance, and long-term trust from global buyers especially in the US and Europe, where quality and traceability standards are tightening.
A More Realistic Path Forward
India doesn’t need to replace China entirely. It just needs to reduce its vulnerability. That means focusing on high-risk APIs like antibiotics and vitamins, ensuring bulk drug parks deliver genuinely low cost utilities, and encouraging large pharma companies to commit to long-term domestic sourcing contracts.
If India prioritises fermentation based drugs, builds local intermediates to reduce feedstock dependence, and enforces strong quality and traceability standards, it can carve out a resilient base.
Done right, this won’t dethrone China. But it will ensure that the world’s pharmacy isn’t left scrambling when supply chains crack again. And maybe that’s the real test of India’s pharma future, not how much it exports, but how much of its own chemistry it can finally bring home.