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160 Fighting the Diseases of PovertyIn India, Indira Gandhi’s government passed laws in 1972 thatmade it impossible to patent pharmaceutical products, with theresult that the past 33 years have seen practically no new drugscreated within that country to tackle its most pressing diseases.Instead, a large generics industry developed. Yet for all the copies ofmedicines being produced by India’s then 20,000 or more pharmaceuticalcompanies (many of them small-scale ‘mom and pop’ operations),access to medicines in India remained deplorably low,standing at less than 40 per cent in 1999 (Lanjouw, 1999). Inaddition, despite being a global centre for the manufacture ofgeneric AIDS drugs, only 12,000 of India’s 5 million HIV positivecitizens were receiving antiretroviral drugs by the end of 2005(UNAIDS, 2006).India’s implementation of a TRIPS-compliant patent law hasprobably in part reduced the number of companies producing copiesof drugs but it has had no discernable impact on rates of access tomedicines, which almost certainly remain extremely low. Again, thefact is that there are far more serious problems at play which affectaccess to medicines besides intellectual property rights, such as anentirely inadequate medical infrastructure.Nevertheless, the recent changes in India’s intellectual propertylaw already have stimulated Indian firms to develop drugs fordiseases that predominantly affect the local population. Forinstance, Nicholas Piramal has recently opened a US $20 millionresearch and development centre in Bombay to carry out basicresearch in a wide range of health problems, ranging from cancer tomalaria. Ranbaxy (India’s largest pharmaceutical company) and Dr.Reddy’s are also pursuing similar R&D projects. India currently hasthe largest number of FDA approved pharmaceutical manufacturingcompanies outside the US, and has increased spending on R&D from4 per cent, five years ago, to 8 per cent today. 24The change in patent law is also attracting significant foreigninvestment. Multi-national pharmaceutical companies such asMerck and Bristol-Meyers Squibb now see India as a prime locationfor establishing research facilities. India is attractive not only