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PROLOGUEBiotechnology And DrugsThe rise of global trade presents new opportunities and pitfalls for many once-poor nations largely denied economic prosperity in the past. They now compete for overseas markets in industrialized countries—and consumers in those countries benefit from lower prices. But globalization typically has a darker side as well. Both sides of the story are evident in the pharmaceutical industries of China and India. For years these countries have been leaders in the low-cost production of both active pharmaceutical ingredients and the fillers that go into medicines. In China, there are now more than 5,000 companies manufacturing low-cost drugs for domestic and international consumption. Whats more, with overseas markets booming, nearly half of all drugs consumed worldwide can trace their origins to components produced in China. The drive to maintain these markets can create powerful incentives to cut costs at the expense of quality. In the wake of widely reported deaths from tainted Chinese products, such as the recent case of heparin, foreign purchasers trust in the entire industry has waned. In India, globalization has brought different temptations. Following on the heels of that nations success with production of generics, its pharmaceutical producers have now turned to accelerated development of innovative and patented molecular compounds and biologics. These lucrative products offer higher returns and the opportunity to compete head to head with European producers. Yet there are concerns that Indian manufacturers may now lack sufficient incentive to produce low-cost generic varieties of drugs for diseases that disproportionately burden poor people, both in India and around the world. The papers that follow address these dilemmas. Sarah Frew, Hannah Kettler, and Peter Singer of the University of Toronto and the Bill and Melinda Gates Foundation offer a vision of a biotech marketplace that rewards innovative companies that continue to tackle diseases affecting the poor. But such a marketplace, they write, will require special incentives and "intentional policies" to target investment appropriately. Its no easy task to get these incentives right, as Qiang Sun (Shandong University) and colleagues discuss in their study of Chinas pharmaceutical policies. Government initiatives to reduce domestic drug spending and increase innovation have sometimes misfired, leading to unexpected market responses felt across the global village.
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