India, Oct. 18 -- On September 29, the United States imposed a 100% tariff on certain patented pharmaceutical imports. India was among just 20 countries granted an exemption for eligible specialty medicines, while generics remained outside the scope of the measure. The exemption is welcome, but it highlights a deeper reality: access to the world's largest pharmaceutical market can change with policy decisions made abroad. As India seeks to become a global centre for pharmaceutical innovation, the domestic market will become more important, not less. Export opportunities matter, but innovation ecosystems are ultimately built on reliable demand at home.

China offers a useful lesson. Its rise as a pharmaceutical innovation powerhouse was dr...